RICHARD MARK PORT DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****81

License Status

NOT RENEWED

Business

First Name

RICHARD MARK

Last Name

PORT

Suffix

DDS

Business Name

RICHARD MARK PORT DDS

Original Issue Date

01/01/1998

Effective Date

10/22/2021

Expiration Date

09/30/2024

City

LINCOLNSHIRE

State

Zip

60069

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025