MARK DARYL STUMPHY DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****45

License Status

NOT RENEWED

Business

Title

DDS

First Name

MARK

Middle

DARYL

Last Name

STUMPHY

Business Name

MARK DARYL STUMPHY DDS

Original Issue Date

01/31/2013

Effective Date

01/31/2013

Expiration Date

09/30/2015

City

JOLIET

State

Zip

60436

County

WILL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016