BRENDAN M FONG MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036158187

License Status

ACTIVE

Business

Title

First Name

BRENDAN

Middle

Last Name

FONG

Business Name

BRENDAN M FONG MD

Original Issue Date

08/31/2021

Effective Date

06/08/2023

Expiration Date

07/31/2026

City

O FALLON

State

Zip

62269

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

06/08/2023