JOANNA MARIE FERNANDEZ POLISTICO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036132409

License Status

NOT RENEWED

Business

Title

First Name

JOANNA MARIE

Middle

FERNANDEZ

Last Name

POLISTICO

Business Name

JOANNA MARIE FERNANDEZ POLISTICO MD

Original Issue Date

04/12/2013

Effective Date

04/15/2014

Expiration Date

07/31/2017

City

MT VERNON

State

Zip

62864

County

JEFFERSON

Ever Disciplined

LastModifiedDate

11/01/2017