LUIS FERNANDO GOMEZ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****89

License Status

NOT RENEWED

Business

First Name

LUIS

Middle

FERNANDO

Last Name

GOMEZ

Suffix

Business Name

LUIS FERNANDO GOMEZ MD

Original Issue Date

06/16/1999

Effective Date

06/16/1999

Expiration Date

07/31/2005

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

04/07/2011