RICHARD H BONGARD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****08

License Status

NOT RENEWED

Business

First Name

RICHARD H

Last Name

BONGARD

Suffix

Business Name

RICHARD H BONGARD MD

Original Issue Date

07/19/1990

Effective Date

07/19/1990

Expiration Date

07/31/1996

City

MIDLOTHIAN

State

Zip

60445

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020