MARK GREGORY BRUNK Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****56

License Status

ACTIVE

Business

First Name

MARK GREGORY

Last Name

BRUNK

Business Name

MARK GREGORY BRUNK

Original Issue Date

03/18/1985

Effective Date

09/12/2024

Expiration Date

09/30/2027

City

VANDALIA

State

Zip

62471

County

FAYETTE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/12/2024