MARK D LENZ DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019026890

License Status

INACTIVE

Business

First Name

MARK

Middle

Last Name

LENZ

Suffix

DDS

Business Name

MARK D LENZ DDS

Original Issue Date

09/30/2005

Effective Date

09/30/2004

Expiration Date

09/30/2006

City

RACINE

State

Zip

53406

County

WISCONSIN

Ever Disciplined

LastModifiedDate

07/24/2006