JUDE ATABONG AGENDIA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125048473

License Status

CANCELLED

Business

First Name

JUDE

Middle

ATABONG

Last Name

AGENDIA

Suffix

Business Name

JUDE ATABONG AGENDIA MD

Original Issue Date

07/01/2004

Effective Date

07/01/2004

Expiration Date

06/30/2007

City

CHICAGO

State

Zip

60649

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006