MARK J CHICOINE Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****56

License Status

NOT RENEWED

Business

First Name

MARK

Middle

Last Name

CHICOINE

Business Name

MARK J CHICOINE

Original Issue Date

06/22/2012

Effective Date

06/22/2012

Expiration Date

09/30/2015

City

CHICAGO

State

Zip

60614

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016