CARLOS RAFAEL DA FONSECA MD Medical Doctor License verification

CARLOS RAFAEL DA FONSECA MD

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036122089

License Status

NOT RENEWED

Business

First Name

CARLOS

Middle

RAFAEL

Last Name

DA FONSECA

Suffix

Business Name

CARLOS RAFAEL DA FONSECA MD

Original Issue Date

10/21/2008

Effective Date

04/24/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

01/14/2021

Case Number

2019001780

Action

Suspension

Discipline Start Date

03/10/2020

Discipline Reason

physician and surgeon license indefinitely suspended for a minimum of one year due to clinical privileges being suspended at Sinai Medical Group for improper controlled substance prescribing and boundary violation with one patient.