LIYANAGE WIMAL S FERNANDO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****82

License Status

NOT RENEWED

Business

First Name

LIYANAGE WIMAL S

Last Name

FERNANDO

Suffix

Business Name

LIYANAGE WIMAL S FERNANDO MD

Original Issue Date

06/25/1981

Effective Date

06/25/1981

Expiration Date

07/31/1996

City

BELVIDERE

State

Zip

61008

County

BOONE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011