MARC PERICLES MANOS DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****46

License Status

ACTIVE

Business

Title

DMD

First Name

MARC

Middle

PERICLES

Last Name

MANOS

Business Name

MARC PERICLES MANOS DMD

Original Issue Date

07/21/2015

Effective Date

08/14/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60614

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/14/2024