SAMUEL C FERNANDO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036046129

License Status

NOT RENEWED

Business

First Name

SAMUEL C

Last Name

FERNANDO

Suffix

Business Name

SAMUEL C FERNANDO MD

Original Issue Date

08/17/1972

Effective Date

04/25/2011

Expiration Date

07/31/2014

City

INDIAN HEAD PARK

State

Zip

60525

County

COOK

Ever Disciplined

LastModifiedDate

09/03/2019

Case Number

2006004299

Action

Suspension

Discipline Start Date

01/02/2007

Discipline End Date

01/01/2008

Discipline Reason

violated state and federal controlled substance laws and statutes.