RAM MOHAN R BONGU MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****74

License Status

NOT RENEWED

Business

First Name

RAM MOHAN R

Last Name

BONGU

Suffix

Business Name

RAM MOHAN R BONGU MD

Original Issue Date

07/29/1997

Effective Date

07/29/1997

Expiration Date

07/31/2005

City

PARK RIDGE

State

Zip

60068

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020