FERNANDO ANTHONY CARBALLO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****88

License Status

NOT RENEWED

Business

First Name

FERNANDO ANTHONY

Last Name

CARBALLO

Suffix

Business Name

FERNANDO ANTHONY CARBALLO MD

Original Issue Date

09/21/1992

Effective Date

09/21/1992

Expiration Date

07/31/1999

City

STERLING

State

Zip

61081

County

WHITESIDE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011