MARK WATANABE DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****90

License Status

NOT RENEWED

Business

First Name

MARK

Last Name

WATANABE

Suffix

DDS

Business Name

MARK WATANABE DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/1990

City

WHEATON

State

Zip

60187

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005