FONDA R PEDERSEN DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****30

License Status

ACTIVE

Business

First Name

FONDA R

Last Name

PEDERSEN

Suffix

DDS

Business Name

FONDA R PEDERSEN DDS

Original Issue Date

08/29/1988

Effective Date

10/01/2024

Expiration Date

09/30/2027

City

NORWOOD PARK

State

Zip

60631

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2024