HARRY EDUARDO FUENTES-BAYNE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****51

License Status

NOT RENEWED

Business

Title

First Name

HARRY

Middle

EDUARDO

Last Name

FUENTES-BAYNE

Business Name

HARRY EDUARDO FUENTES-BAYNE MD

Original Issue Date

02/08/2017

Effective Date

05/01/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60608

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021