ENRIQUE C FERNANDEZ

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****67

NOT RENEWED

N

ENRIQUE

C

FERNANDEZ

ENRIQUE C FERNANDEZ

08/26/2002

08/26/2002

07/31/2005

CHICAGO

IL

60622

COOK

II III IV V

N

10/09/2006