The holder whose full name is Fuentes, Henry J.,come from Palos Heights IL,hold the Physician license(NO.01040355A) which status is Expired Non-Renewable.
| Name | Fuentes, Henry J. |
|---|---|
| License Number | 01040355A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | Palos Heights |
| State | IL |