RAFAEL F PENA Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****72

License Status

ACTIVE

Business

First Name

RAFAEL F

Last Name

PENA

Business Name

RAFAEL F PENA

Original Issue Date

11/06/1985

Effective Date

09/20/2024

Expiration Date

09/30/2027

City

ARLINGTON HEIGHTS

State

Zip

60004

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/20/2024