JORGE E FERNALD MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125028565

License Status

EXPIRED

Business

First Name

JORGE

Middle

Last Name

FERNALD

Suffix

Business Name

JORGE E FERNALD MD

Original Issue Date

06/03/1992

Effective Date

06/03/1992

Expiration Date

06/14/1995

City

MAYWOOD

State

Zip

60153

County

COOK

Ever Disciplined

LastModifiedDate

05/11/2010