ny medical license
TRANSCRIPT
To: Licensee/Registrant
1l please review the Registration Certificate below to be sure the information on it is correct.
a If any of the information is not correct, please contact us at [email protected] or
(518) 474-3817, Ext. 410.
O If the information is coffect, sign above the Licensee/Registrant block and please destroy any
previous Registration Certificates you may haye, as certificates with incorrect information are
not valid and should not be kePt.
i Should your address or name change, please notify us as described on the reverse and a new
certificate will be issued.
UPON RECEIPT OF TI{IS REGISTRATION CERTIFICATE YOUR PREVIOUSLY
ISSUBD REGISTRATION CERTIFICATE IS NTJLL AND VOID. PLEASE DBSTROY
THE PREVIOUSLY ISSUED REGISTRATION CERTIFICATE.
SEE BACK FOR MPORTANT INFORMATION
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The University of the State of Ndw YorkE du c atio n' D e p artm, e' ni
: ,'Office of,the Piofestts,i ,s":,'.
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Rn GI S r N.qT T ON ..C
ERE I F I C A..T EDo not uccept a copy of this ceSfic,gte
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FERNANDEZ CAROLINEP.O.BOX714", , i:,i
EAST AMHERST
to practice in New York State. ]. . PHY,SICtrAN
This document is valid oily if it has not expired, nane and address or" "oo""t,'
it hoq not been titmperyl/ with ttnd is an
oiginal - ,ot o copy. To veify that this registrarion gertifcate is valid or far mpre iaformalioit please visit'.,:,,', " . ,' :www.ap.:;nysed-gov. .. ':::::r::r
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CertifiCate Numtier: 9237325
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NY 14051-0000
through o1/3112018 as a(n)
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SSIONER OF EDUCATION
DEPt'fY EOMMISSTONERFOR THE PR,OFESSIONS
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