MARK WINSTON BRAITHWAITE DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****43

License Status

NOT RENEWED

Business

First Name

MARK

Middle

WINSTON

Last Name

BRAITHWAITE

Suffix

DDS

Business Name

MARK WINSTON BRAITHWAITE DDS

Original Issue Date

11/01/2000

Effective Date

11/01/2000

Expiration Date

09/30/2006

City

HINES

State

Zip

60141

County

COOK

Controlled Substance Schedule

III IV

Ever Disciplined

LastModifiedDate

11/08/2006