FRED J DE LA COTERA DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****37

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

10/29/2023

Effective Date

08/08/2024

Expiration Date

09/30/2027

City

GRAYSLAKE

State

Zip

60030

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/08/2024