DEEPIKA BONGU Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036106132

License Status

INACTIVE

Business

First Name

DEEPIKA

Last Name

BONGU

Business Name

DEEPIKA BONGU

Original Issue Date

01/22/2002

Effective Date

08/24/2020

Expiration Date

07/31/2023

City

FAYETTEVILLE

State

Zip

28314

County

NORTH CAROLINA

Ever Disciplined

LastModifiedDate

05/15/2023