FAITH DOMINGO FUENTES Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125019561

License Status

EXPIRED

Business

First Name

FAITH DOMINGO

Last Name

FUENTES

Business Name

FAITH DOMINGO FUENTES

Original Issue Date

06/18/1986

Effective Date

06/18/1986

Expiration Date

07/01/1989

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Neurology

Ever Disciplined

LastModifiedDate

09/22/2006