ANDREA ESTE FANIA REALE REYES DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****90

License Status

ACTIVE

Business

Title

DDS

First Name

ANDREA

Middle

ESTE FANIA

Last Name

REALE REYES

Business Name

ANDREA ESTE FANIA REALE REYES DDS

Original Issue Date

04/19/2022

Effective Date

09/27/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60618

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/27/2024