JUDE ATABONG AGENDIA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****47

License Status

ACTIVE

Business

First Name

JUDE

Middle

ATABONG

Last Name

AGENDIA

Suffix

Business Name

JUDE ATABONG AGENDIA MD

Original Issue Date

05/04/2007

Effective Date

06/28/2023

Expiration Date

07/31/2026

City

LAKE CHARLES

State

Zip

70605

County

LOUISIANA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/28/2023