CHRISTIANNA POTTER FAULCON Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****89

License Status

ACTIVE

Business

First Name

CHRISTIANNA

Middle

POTTER

Last Name

FAULCON

Business Name

CHRISTIANNA POTTER FAULCON

Original Issue Date

08/16/2022

Effective Date

05/01/2024

Expiration Date

09/30/2027

City

ALGONQUIN

State

Zip

60102

County

MCHENRY

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/12/2024