RICHARD N FACKO Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****73

License Status

ACTIVE

Business

First Name

RICHARD

Middle

Last Name

FACKO

Business Name

RICHARD N FACKO

Original Issue Date

05/12/2010

Effective Date

05/01/2024

Expiration Date

09/30/2027

City

PALOS HEIGHTS

State

Zip

60463

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/01/2024