CATALINA A FERNALD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****70

License Status

CANCELLED

Business

First Name

CATALINA A

Last Name

FERNALD

Business Name

CATALINA A FERNALD

Original Issue Date

07/16/1996

Effective Date

07/15/2008

Expiration Date

07/31/2011

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011