License Search: Details

Name	Title	Specialty	Certified	Primary Practice Location	Licensed Or Has Been Licensed In
Carlos Fernandez De Lara	MD	Clinical Pathology	Verify Specialty Certification	1088 Green Meadow Rd. Charleston, Wv Part Time CHARLESTON, WV (Kanawha)	NJ, NY, OH, WV

License History

License Type	License Number	Status	License Date	Expiration Date
PMD	10126	Surrendered	07/08/1974	11/02/2015

Education History

School	Date Completed	Nature of Training
Dr Nicanor Reyes Medical Foundation Institute Of Med, Far Eastern Univ	12/13/1963	Medical or Podiatric School
Presby Unit Hospital, Newark	6/30/1965	Post-Graduate Training
Orange Mem Hospital, Orange	6/30/1967	Post-Graduate Training
Va Hsopital, East Orange	6/30/1970	Post-Graduate Training

Physician Assistant(s) Collaboration

Name
No Current Supervision

Discipline/Board Action History

Discipline/Board Action	Type of Action	Action Date	Public Documents
Yes	Voluntary Surrender of License	10/15/2015	Consent Order

Malpractice History

No Malpractice Cases On Record

This data was retrieved on 4/6/2026.