DEREK H FORNELLI DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019028021

License Status

ACTIVE

Business

First Name

DEREK

Middle

Last Name

FORNELLI DDS

Business Name

DEREK H FORNELLI DDS

Original Issue Date

06/18/2009

Effective Date

09/30/2024

Expiration Date

09/30/2027

City

PARK RIDGE

State

Zip

60068

County

COOK

Ever Disciplined

LastModifiedDate

09/30/2024