JOHN KENNETH FAVALE Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****74

License Status

ACTIVE

Business

First Name

JOHN KENNETH

Last Name

FAVALE

Business Name

JOHN KENNETH FAVALE

Original Issue Date

08/02/1983

Effective Date

07/26/2024

Expiration Date

09/30/2027

City

LINDENHURST

State

Zip

60046

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/26/2024