JOHN NKI FONGE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125065639

License Status

CANCELLED

Business

First Name

JOHN

Middle

NKI

Last Name

FONGE

Suffix

Business Name

JOHN NKI FONGE MD

Original Issue Date

07/01/2017

Effective Date

07/01/2017

Expiration Date

06/30/2018

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

Internal Medicine/Pediatrics

Ever Disciplined

LastModifiedDate

04/03/2017