TAFOR NGWANU BONU MOCHUNGONG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****37

License Status

NOT RENEWED

Business

Title

First Name

TAFOR

Middle

NGWANU

Last Name

BONU MOCHUNGONG

Business Name

TAFOR NGWANU BONU MOCHUNGONG MD

Original Issue Date

10/24/2021

Effective Date

10/24/2021

Expiration Date

07/31/2023

City

PEORIA

State

Zip

61615

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023