ROBERT FONG MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125056492

License Status

CANCELLED

Business

Title

First Name

ROBERT

Last Name

FONG

Business Name

ROBERT FONG MD

Original Issue Date

07/01/2012

Effective Date

07/01/2012

Expiration Date

06/30/2013

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

04/17/2012