MARK ANTHONY MACAK DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****41

License Status

ACTIVE

Business

Title

DMD

First Name

MARK

Middle

ANTHONY

Last Name

MACAK

Business Name

MARK ANTHONY MACAK DMD

Original Issue Date

10/29/2023

Effective Date

08/29/2024

Expiration Date

09/30/2027

City

NORTHLAKE

State

Zip

60164

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/29/2024