MARK THOMAS HEWLETT Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****99

License Status

ACTIVE

Business

First Name

MARK

Middle

THOMAS

Last Name

HEWLETT

Business Name

MARK THOMAS HEWLETT

Original Issue Date

09/20/2005

Effective Date

09/15/2024

Expiration Date

09/30/2027

City

GRANITE CITY

State

Zip

62040

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/15/2024