GASPAR MIGUEL FERNANDEZ MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125027162

License Status

EXPIRED

Business

First Name

GASPAR

Middle

MIGUEL

Last Name

FERNANDEZ

Suffix

Business Name

GASPAR MIGUEL FERNANDEZ MD

Original Issue Date

06/12/1991

Effective Date

06/12/1991

Expiration Date

06/30/1994

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

09/22/2006