RODRIGUE FONKA FONTEM MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125077903

License Status

EXPIRED

Business

Title

First Name

RODRIGUE

Middle

FONKA

Last Name

FONTEM

Business Name

RODRIGUE FONKA FONTEM MD

Original Issue Date

08/01/2021

Effective Date

08/01/2021

Expiration Date

07/31/2022

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Colon and Rectal Surgery

Ever Disciplined

LastModifiedDate

10/11/2022