JACQUELINE THOMPSON-FERNANDEZ Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****23

License Status

NOT RENEWED

Business

First Name

JACQUELINE

Last Name

THOMPSON-FERNANDEZ

Business Name

JACQUELINE THOMPSON-FERNANDEZ

Original Issue Date

10/02/1986

Effective Date

10/02/1986

Expiration Date

09/30/1990

City

EVANSTON

State

Zip

60201

County

COOK

Controlled Substance Schedule

II III

Ever Disciplined

LastModifiedDate

10/13/2005