DENNIS Y FONG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****94

License Status

NOT RENEWED

Business

First Name

DENNIS Y

Last Name

FONG

Suffix

Business Name

DENNIS Y FONG MD

Original Issue Date

02/26/1996

Effective Date

02/26/1996

Expiration Date

07/31/1996

City

PEORIA

State

Zip

61615

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020