TAFOR NGWANU BONU MOCHUNGONG MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125075087

License Status

CANCELLED

Business

Title

First Name

TAFOR

Middle

NGWANU

Last Name

BONU MOCHUNGONG

Business Name

TAFOR NGWANU BONU MOCHUNGONG MD

Original Issue Date

07/01/2019

Effective Date

07/01/2019

Expiration Date

06/30/2022

City

PEORIA

State

Zip

61605

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

06/17/2019