MARK WILLIAM GARDNER Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****54

License Status

NOT RENEWED

Business

First Name

MARK WILLIAM

Last Name

GARDNER

Business Name

MARK WILLIAM GARDNER

Original Issue Date

01/31/1986

Effective Date

01/31/1986

Expiration Date

09/30/1990

City

CHICAGO

State

Zip

60614

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005