MARK A FERNANDEZ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****41

License Status

NOT RENEWED

Business

First Name

MARK A

Last Name

FERNANDEZ

Suffix

Business Name

MARK A FERNANDEZ MD

Original Issue Date

11/23/1994

Effective Date

11/23/1994

Expiration Date

07/31/2005

City

PERU

State

Zip

61354

County

LA SALLE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020