VIVIANA MARCELA FAJARDO MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125061706

License Status

EXPIRED

Business

Title

First Name

VIVIANA

Middle

MARCELA

Last Name

FAJARDO

Business Name

VIVIANA MARCELA FAJARDO MD

Original Issue Date

06/22/2012

Effective Date

06/22/2012

Expiration Date

06/21/2015

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/04/2015