MARK ALLEN ROSE DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****91

License Status

ACTIVE

Business

First Name

MARK ALLEN

Last Name

ROSE

Suffix

DMD

Business Name

MARK ALLEN ROSE DMD

Original Issue Date

11/06/1997

Effective Date

07/22/2024

Expiration Date

09/30/2027

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

07/22/2024