EVA TERESA FORTSAS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****40

License Status

ACTIVE

Business

First Name

EVA

Middle

TERESA

Last Name

FORTSAS

Business Name

EVA TERESA FORTSAS

Original Issue Date

08/31/2001

Effective Date

09/10/2024

Expiration Date

09/30/2027

City

WAUKEGAN

State

Zip

60085

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/10/2024