MARK P COLONNA Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****39

License Status

NOT RENEWED

Business

First Name

MARK P

Last Name

COLONNA

Business Name

MARK P COLONNA

Original Issue Date

10/24/1983

Effective Date

10/24/1983

Expiration Date

09/30/1994

City

ST CHARLES

State

Zip

60174

County

KANE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005