MARK A FERNANDEZ MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****42

License Status

ACTIVE

Business

First Name

MARK A

Last Name

FERNANDEZ

Suffix

Business Name

MARK A FERNANDEZ MD

Original Issue Date

02/09/1995

Effective Date

04/28/2023

Expiration Date

07/31/2026

City

PERU

State

Zip

61354

County

LA SALLE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/28/2023