NEKAELA KIANA ORTEGA EDRALIN Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****75

License Status

ACTIVE

Business

First Name

NEKAELA

Middle

KIANA ORTEGA

Last Name

EDRALIN

Business Name

NEKAELA KIANA ORTEGA EDRALIN

Original Issue Date

08/03/2022

Effective Date

09/17/2024

Expiration Date

09/30/2027

City

OAK PARK

State

Zip

60302

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/17/2024