MARK STEPHEN DAVIS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****50

License Status

NOT RENEWED

Business

First Name

MARK STEPHEN

Last Name

DAVIS

Business Name

MARK STEPHEN DAVIS

Original Issue Date

09/21/1984

Effective Date

09/21/1984

Expiration Date

09/30/1994

City

BLOOMINGDALE

State

Zip

60108

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005