FERNANDO B BONANNI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****37

License Status

ACTIVE

Business

First Name

FERNANDO

Middle

Last Name

BONANNI

Suffix

Business Name

FERNANDO B BONANNI MD

Original Issue Date

11/01/2019

Effective Date

04/18/2023

Expiration Date

07/31/2026

City

QUINCY

State

Zip

62301

County

ADAMS

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/18/2023