LUVIANCA J FONSECA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****49

License Status

ACTIVE

Business

First Name

LUVIANCA

Middle

Last Name

FONSECA

Suffix

Business Name

LUVIANCA J FONSECA MD

Original Issue Date

10/03/2001

Effective Date

06/07/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60629

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/07/2023