RAFAEL DE JESUS FERNANDEZ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****45

License Status

NOT RENEWED

Business

First Name

RAFAEL DE JESUS

Last Name

FERNANDEZ

Suffix

Business Name

RAFAEL DE JESUS FERNANDEZ MD

Original Issue Date

07/16/1986

Effective Date

07/16/1986

Expiration Date

07/31/1999

City

CHICAGO

State

Zip

60638

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020