DOMINIQUE KATHRYN FONS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****80

License Status

ACTIVE

Business

First Name

DOMINIQUE

Middle

KATHRYN

Last Name

FONS

Suffix

Business Name

DOMINIQUE KATHRYN FONS MD

Original Issue Date

06/27/2011

Effective Date

04/29/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61602

County

CHAMPAIGN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/29/2023