MARK DAVID DUTZ 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

First Name

MARK DAVID

Last Name

DUTZ

Suffix

DDS

Business Name

MARK DAVID DUTZ DDS

Original Issue Date

01/01/1998

Effective Date

06/09/2009

Expiration Date

09/30/2012

City

TREMONT

State

Zip

61668

County

TAZEWELL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012