RICHARD N FACKO Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000850

License Status

NOT RENEWED

Business

First Name

RICHARD

Middle

Last Name

FACKO

Business Name

RICHARD N FACKO

Original Issue Date

08/22/2012

Effective Date

10/06/2021

Expiration Date

09/30/2024

City

PALOS HEIGHTS

State

Zip

60463

County

COOK

Specialty/Qualifier

CONSCIOUS SEDATION, PARENTERAL

Ever Disciplined

LastModifiedDate

02/04/2025