MARK SAMUEL ANTMAN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****46

License Status

NOT RENEWED

Business

First Name

MARK SAMUEL

Last Name

ANTMAN

Business Name

MARK SAMUEL ANTMAN

Original Issue Date

11/21/1983

Effective Date

11/21/1983

Expiration Date

09/30/1990

City

SKOKIE

State

Zip

60077

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005