ABRAHAM EMPERADOR FONTANILLA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****24

License Status

NOT RENEWED

Business

Title

First Name

ABRAHAM

Middle

EMPERADOR

Last Name

FONTANILLA

Business Name

ABRAHAM EMPERADOR FONTANILLA MD

Original Issue Date

09/09/2010

Effective Date

05/22/2014

Expiration Date

07/31/2017

City

WATSEKA

State

Zip

60970

County

IROQUOIS

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017