DELIA TORRES FERNALD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****80

License Status

NOT RENEWED

Business

First Name

DELIA TORRES

Last Name

FERNALD

Business Name

DELIA TORRES FERNALD

Original Issue Date

08/17/1982

Effective Date

09/24/2012

Expiration Date

09/30/2015

City

MORTON GROVE

State

Zip

60053

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016