ANNA DE LA FUENTE DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****69

License Status

ACTIVE

Business

Title

DMD

First Name

ANNA

Last Name

DE LA FUENTE

Business Name

ANNA DE LA FUENTE DMD

Original Issue Date

07/23/2015

Effective Date

05/04/2024

Expiration Date

09/30/2027

City

ELGIN

State

Zip

60120

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/04/2024