BASIL S HERNANDEZ Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****03

License Status

ACTIVE

Business

First Name

BASIL

Middle

Last Name

HERNANDEZ

Business Name

BASIL S HERNANDEZ

Original Issue Date

08/11/2006

Effective Date

06/09/2023

Expiration Date

07/31/2026

City

OSWEGO

State

Zip

60543

County

KENDALL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/01/2023