PABLO ANDRES FERNANDEZ Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****53

License Status

NOT RENEWED

Business

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

City

HALES CORNERS

State

Zip

53130

County

WISCONSIN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018