RAFAEL ALBERTO FERNANDEZ BOHORQUEZ Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125052090

License Status

EXPIRED

Business

First Name

RAFAEL

Middle

ALBERTO

Last Name

FERNANDEZ BOHORQUEZ

Business Name

RAFAEL ALBERTO FERNANDEZ BOHORQUEZ

Original Issue Date

07/01/2006

Effective Date

07/01/2006

Expiration Date

06/30/2009

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

07/15/2009