ANTHONY M FERNANDEZ Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125042536

License Status

EXPIRED

Business

First Name

ANTHONY

Middle

Last Name

FERNANDEZ

Business Name

ANTHONY M FERNANDEZ

Original Issue Date

06/25/2001

Effective Date

06/25/2001

Expiration Date

06/24/2004

City

BERWYN

State

Zip

60402

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006