MARK WILLIAM ANDERSON DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****89

License Status

ACTIVE

Business

First Name

MARK

Middle

WILLIAM

Last Name

ANDERSON

Suffix

DDS

Business Name

MARK WILLIAM ANDERSON DDS

Original Issue Date

02/23/1999

Effective Date

09/25/2024

Expiration Date

09/30/2027

City

DANVILLE

State

Zip

61832

County

VERMILION

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/25/2024