DAPHNE PONCE TUMANENG DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125043199

License Status

EXPIRED

Business

First Name

DAPHNE

Middle

PONCE

Last Name

TUMANENG

Suffix

Business Name

DAPHNE PONCE TUMANENG DO

Original Issue Date

07/01/2001

Effective Date

07/01/2001

Expiration Date

06/30/2002

City

CHICAGO

State

Zip

60657

Ever Disciplined

LastModifiedDate

09/22/2006