ENRIQUE C FERNANDEZ Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125042073

License Status

EXPIRED

Business

First Name

ENRIQUE

Middle

Last Name

FERNANDEZ

Business Name

ENRIQUE C FERNANDEZ

Original Issue Date

07/18/2000

Effective Date

07/18/2000

Expiration Date

07/17/2003

City

CHICAGO

State

Zip

60622

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006