MARK WILLIAM ANDERSON Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****51

License Status

ACTIVE

Business

First Name

MARK WILLIAM

Last Name

ANDERSON

Business Name

MARK WILLIAM ANDERSON

Original Issue Date

08/24/1983

Effective Date

09/09/2024

Expiration Date

09/30/2027

City

BLUE ISLAND

State

Zip

60406

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/09/2024