FRED J DE LA COTERA DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****67

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

12/05/1986

Effective Date

08/08/2024

Expiration Date

09/30/2027

City

ELMWOOD PARK

State

Zip

60707

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/08/2024