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Ukonu
Ukonu
Ejie
Medical doctor
Ormond Beach, United States
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Florida Health Care Practitioner Data Portal
Full name
UKONU EJIE
Job Title
Medical Doctor
Location
Ormond Beach, FL, USA
LIC ID
83874
Current License Expiration Date
31/01/2025
Original Date
30/12/2002
Professional Rank Code
ME
Effective Date
30/12/2002
Board Action Indicator
N
License Status Description
CLEAR
License Active Status Description
ACTIVE
Country Description
VOLUSIA
Practice Location Address Line 1
104 LaCosta Lane, Suite 120
Practice Location Address Line 2
104 LACOSTA LANE SUITE 120
Practice Location Address City
DAYTONA BEACH
Practice Location Address State
FL
Practice Location Address Zipcode
32114
Mode Code
Dispensing Practitioner
Prescribing Indicator
N
Dispensing Indicator
Y
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