BERNICE M FOKUM MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****59

License Status

ACTIVE

Business

Title

First Name

BERNICE

Middle

Last Name

FOKUM

Business Name

BERNICE M FOKUM MD

Original Issue Date

05/26/2023

Effective Date

05/26/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62712

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/26/2023