PABLO ANDRES FERNANDEZ - Dentist License in Wisconsin | # 31*****53

PABLO ANDRES FERNANDEZ

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****53

License Status

NOT RENEWED

Business

N

First Name

PABLO

Middle

ANDRES

Last Name

FERNANDEZ

Business Name

PABLO ANDRES FERNANDEZ

Original Issue Date

08/04/2015

Effective Date

08/04/2015

Expiration Date

09/30/2018

State

WI

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

N

LastModifiedDate

10/31/2018