MARK BENAVIDES Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****87

License Status

ACTIVE

Business

First Name

MARK

Last Name

BENAVIDES

Business Name

MARK BENAVIDES

Original Issue Date

09/30/1986

Effective Date

05/07/2025

Expiration Date

09/30/2027

City

OTTAWA

State

Zip

61350

County

LA SALLE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/04/2025