FERNANDO ANTHONY CARBALLO MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125025568

License Status

EXPIRED

Business

First Name

FERNANDO ANTHONY

Last Name

CARBALLO

Suffix

Business Name

FERNANDO ANTHONY CARBALLO MD

Original Issue Date

06/19/1990

Effective Date

06/19/1990

Expiration Date

06/30/1993

City

BERWYN

State

Zip

60402

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006