MARK H BAUMGARTNER DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****97

License Status

NOT RENEWED

Business

First Name

MARK

Middle

Last Name

BAUMGARTNER

Suffix

DMD

Business Name

MARK H BAUMGARTNER DMD

Original Issue Date

12/10/2004

Effective Date

07/24/2006

Expiration Date

09/30/2009

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/04/2009