RICHARD P FERNANDEZ Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****07

License Status

NOT RENEWED

Business

First Name

RICHARD

Middle

Last Name

FERNANDEZ

Business Name

RICHARD P FERNANDEZ

Original Issue Date

04/06/2005

Effective Date

06/06/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60619

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014