FERNANDINO ANG FONTANILLA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125038572

License Status

EXPIRED

Business

First Name

FERNANDINO

Middle

ANG

Last Name

FONTANILLA

Suffix

Business Name

FERNANDINO ANG FONTANILLA MD

Original Issue Date

07/01/1998

Effective Date

07/01/1998

Expiration Date

12/08/2000

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Ophthalmology

Ever Disciplined

LastModifiedDate

09/22/2006