MARK EVAN GLESNE DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****93

License Status

NOT RENEWED

Business

First Name

MARK EVAN

Last Name

GLESNE

Suffix

DDS

Business Name

MARK EVAN GLESNE DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/2004

City

DELAVAN

State

Zip

61734

County

TAZEWELL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005