LAUREL VANA FRAUSTO DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****46

License Status

ACTIVE

Business

Title

DMD

First Name

LAUREL

Middle

VANA

Last Name

FRAUSTO

Business Name

LAUREL VANA FRAUSTO DMD

Original Issue Date

08/09/2018

Effective Date

07/19/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60622

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/19/2024