EVELYN FORNAGIEL DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****89

License Status

ACTIVE

Business

Title

DMD

First Name

EVELYN

Last Name

FORNAGIEL

Business Name

EVELYN FORNAGIEL DMD

Original Issue Date

07/10/2024

Effective Date

07/10/2024

Expiration Date

09/30/2027

City

ARLINGTON HTS

State

Zip

60004

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/10/2024