SAMUEL C FERNANDO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****86

License Status

NOT RENEWED

Business

First Name

SAMUEL C

Last Name

FERNANDO

Suffix

Business Name

SAMUEL C FERNANDO MD

Original Issue Date

01/01/1997

Effective Date

04/25/2011

Expiration Date

07/31/2014

City

INDIAN HEAD PARK

State

Zip

60525

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014

Case Number

2006004299

Action

Summary Suspension

Discipline Start Date

01/02/2007

Discipline End Date

01/02/2007

Discipline Reason

Violated state and federal controlled substance statutes and for record keeping violations.