MARK J PROSNIEWSKI DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****31

License Status

NOT RENEWED

Business

First Name

MARK

Middle

Last Name

PROSNIEWSKI

Suffix

DDS

Business Name

MARK J PROSNIEWSKI DDS

Original Issue Date

05/25/2005

Effective Date

07/13/2012

Expiration Date

09/30/2015

City

NORTHLAKE

State

Zip

60164

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016