MARK G BORDEN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****74

License Status

NOT RENEWED

Business

First Name

MARK G

Last Name

BORDEN

Suffix

DDS

Business Name

MARK G BORDEN DDS

Original Issue Date

08/02/1982

Effective Date

08/02/1982

Expiration Date

09/30/1984

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005