CHRISTIAN XAVIER CAICEDO MORENO Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****16

License Status

ACTIVE

Business

First Name

CHRISTIAN

Middle

XAVIER

Last Name

CAICEDO MORENO

Business Name

CHRISTIAN XAVIER CAICEDO MORENO

Original Issue Date

10/01/2019

Effective Date

08/27/2024

Expiration Date

09/30/2027

City

SKOKIE

State

Zip

60077

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/27/2024