GARY PATRICK FERNANDO MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****76

License Status

ACTIVE

Business

Title

First Name

GARY

Middle

PATRICK

Last Name

FERNANDO

Business Name

GARY PATRICK FERNANDO MD

Original Issue Date

07/12/2011

Effective Date

06/13/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61102

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/13/2023