ESTEBAN FERNANDEZ FAITH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****42

License Status

NOT RENEWED

Business

First Name

ESTEBAN

Last Name

FERNANDEZ FAITH

Suffix

Business Name

ESTEBAN FERNANDEZ FAITH MD

Original Issue Date

04/06/2010

Effective Date

04/06/2010

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60614

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

11/10/2011