P ROSE HERNANDEZ Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036069966

License Status

NOT RENEWED

Business

First Name

P ROSE

Last Name

HERNANDEZ

Business Name

P ROSE HERNANDEZ

Original Issue Date

12/10/1984

Effective Date

12/10/1984

Expiration Date

07/31/1999

City

CHICAGO

State

Zip

60617

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006