HUMPHREY WONG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****99

License Status

NOT RENEWED

Business

First Name

HUMPHREY

Last Name

WONG

Suffix

Business Name

HUMPHREY WONG MD

Original Issue Date

10/17/1997

Effective Date

04/29/2014

Expiration Date

07/31/2017

City

SILVIS

State

Zip

61282

County

ROCK ISLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020