ANTHONY M FERNANDEZ Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****66

License Status

NOT RENEWED

Business

First Name

ANTHONY

Middle

Last Name

FERNANDEZ

Business Name

ANTHONY M FERNANDEZ

Original Issue Date

05/31/2006

Effective Date

04/12/2017

Expiration Date

09/30/2020

City

WOODRIDGE

State

Zip

60517

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021