STEPHANE MAC DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****60

License Status

NOT RENEWED

Business

Title

DMD

First Name

STEPHANE

Last Name

MAC

Business Name

STEPHANE MAC DMD

Original Issue Date

10/24/2014

Effective Date

10/24/2014

Expiration Date

09/30/2015

City

HIGHLAND PARK

State

Zip

60035

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016