JOHANNA C FUENTES-VALDES MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****19

License Status

NOT RENEWED

Business

Title

First Name

JOHANNA

Middle

Last Name

FUENTES-VALDES

Business Name

JOHANNA C FUENTES-VALDES MD

Original Issue Date

05/30/2003

Effective Date

05/18/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60661

County

COOK

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

04/08/2014