VIVIAN DE LA C HERNANDEZ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****93

License Status

NOT RENEWED

Business

First Name

VIVIAN DE LA C

Last Name

HERNANDEZ

Suffix

Business Name

VIVIAN DE LA C HERNANDEZ MD

Original Issue Date

12/24/1986

Effective Date

12/24/1986

Expiration Date

07/31/1990

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006