LUVIANCA J FONSECA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125039724

License Status

EXPIRED

Business

First Name

LUVIANCA

Middle

Last Name

FONSECA

Suffix

Business Name

LUVIANCA J FONSECA MD

Original Issue Date

07/01/1999

Effective Date

07/01/1999

Expiration Date

06/30/2002

City

CHICAGO

State

Zip

60622

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006