| Requirement Code | Complied? | Complied Date |
| Renewal Requirements for the year: 2021 | ||
| CPR | requirement complied | 09/27/2021 |
| FEE | requirement complied | 09/27/2021 |
| SIG | requirement complied | 09/27/2021 |
Individual Search Results - Detail
Credential/License Summary for 5968
Name: GUSTAVSON, MARK A
Profession: DENTISTRY (15)
Credential/License Number: 5968-15
Location: MADISON WI
Credential/License Type: regular
Status: License is current (Active)
Eligible To Practice: credential license is current
Credential/License current through: 9/30/2025
Granted date: 4/6/2006
Multi-state: N
Orders: NONE
Specialties: NONE
Other Names:
Mark A Gustavson
| Renewal Year | Amount Paid | Payment Received |
| 2021 | 60 | 09/27/2021 |
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ATTENTION: If a renewal application including payment is received by the renew by date (or Credential/License current through date), the credential holder is eligible to practice while the credential renewal is being processed. The credential holder must respond to any requests for information during the renewal process. See Wis. Stat. ยง 227.51(2).
