FE POBLETE FUENTES MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****15

License Status

NOT RENEWED

Business

First Name

Middle

POBLETE

Last Name

FUENTES

Suffix

Business Name

FE POBLETE FUENTES MD

Original Issue Date

01/01/1997

Expiration Date

07/31/1990

City

CAHOKIA

State

Zip

62206

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2017