CHRISTINE ELYSE PETRILLA DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****12

License Status

ACTIVE

Business

Title

DDS

First Name

CHRISTINE

Middle

ELYSE

Last Name

PETRILLA

Business Name

CHRISTINE ELYSE PETRILLA DDS

Original Issue Date

07/03/2017

Effective Date

09/03/2024

Expiration Date

09/30/2027

City

BOLINGBROOK

State

Zip

60440

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/03/2024