MARK STEPHEN STUMPHY Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****41

License Status

ACTIVE

Business

First Name

MARK

Middle

STEPHEN

Last Name

STUMPHY

Business Name

MARK STEPHEN STUMPHY

Original Issue Date

07/20/2015

Effective Date

07/23/2024

Expiration Date

09/30/2027

City

ROCK ISLAND

State

Zip

61201

County

ROCK ISLAND

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/23/2024