FRED J DE LA COTERA DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000313

License Status

ACTIVE

Business

First Name

FRED J

Last Name

DE LA COTERA

Suffix

DDS

Business Name

FRED J DE LA COTERA DDS

Original Issue Date

05/14/1992

Effective Date

08/08/2024

Expiration Date

09/30/2027

City

ELMWOOD PARK

State

Zip

60707

County

COOK

Specialty/Qualifier

Deep Sedation and General Anesthesia

Ever Disciplined

LastModifiedDate

08/08/2024