ANMARY ALTAGRACIA FERNANDEZ B. MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****50

License Status

NOT RENEWED

Business

Title

First Name

ANMARY

Middle

ALTAGRACIA

Last Name

FERNANDEZ B.

Business Name

ANMARY ALTAGRACIA FERNANDEZ B. MD

Original Issue Date

10/30/2017

Effective Date

10/30/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021