JAVIER FONSECA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****72

License Status

NOT RENEWED

Business

First Name

JAVIER

Last Name

FONSECA

Suffix

Business Name

JAVIER FONSECA MD

Original Issue Date

08/24/1988

Effective Date

08/24/1988

Expiration Date

07/31/1993

City

CHICAGO

State

Zip

60651

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011