WALTER C FONG 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

WALTER C

Last Name

FONG

Suffix

Business Name

WALTER C FONG MD

Original Issue Date

05/06/1981

Effective Date

05/06/1981

Expiration Date

07/31/1984

City

PARK RIDGE

State

Zip

60068

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020