ENRIQUE C FERNANDEZ Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036107733

License Status

NOT RENEWED

Business

First Name

ENRIQUE

Middle

Last Name

FERNANDEZ

Business Name

ENRIQUE C FERNANDEZ

Original Issue Date

08/23/2002

Effective Date

08/23/2002

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60622

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006