JOANNA MARIE FERNANDEZ POLISTICO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****08

License Status

NOT RENEWED

Business

Title

First Name

JOANNA MARIE

Middle

FERNANDEZ

Last Name

POLISTICO

Business Name

JOANNA MARIE FERNANDEZ POLISTICO MD

Original Issue Date

04/12/2013

Effective Date

04/17/2014

Expiration Date

07/31/2017

City

BENTON

State

Zip

62812

County

FRANKLIN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017