ALEXA RAE PRONGA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125078574

License Status

EXPIRED

Business

Title

First Name

ALEXA

Middle

RAE

Last Name

PRONGA

Business Name

ALEXA RAE PRONGA MD

Original Issue Date

07/01/2021

Effective Date

07/01/2021

Expiration Date

06/30/2024

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

10/30/2024