MARK FREEMAN PORTER DMD 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 FREEMAN

Last Name

PORTER

Suffix

DMD

Business Name

MARK FREEMAN PORTER DMD

Original Issue Date

01/01/1998

Effective Date

09/24/2018

Expiration Date

01/31/2022

City

TROY

State

Zip

62294

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022