MARK JOHN CONNELLY Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****38

License Status

NOT RENEWED

Business

First Name

MARK JOHN

Last Name

CONNELLY

Business Name

MARK JOHN CONNELLY

Original Issue Date

06/04/1984

Effective Date

06/04/1984

Expiration Date

09/30/1984

City

ARLINGTON HEIGHTS

State

Zip

60004

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005