JOHN NKI FONGE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****86

License Status

NOT RENEWED

Business

First Name

JOHN

Middle

NKI

Last Name

FONGE

Suffix

Business Name

JOHN NKI FONGE MD

Original Issue Date

09/14/2017

Effective Date

05/04/2020

Expiration Date

07/31/2023

City

PEORIA

State

Zip

61637

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023