DATE: LOCATION:

1st – 6th ICC, Durban

September KwaZulu-Natal
2023 South Africa

Student Chapter Criteria Form

Please complete the form below to provide details about your submission.
Title

Doctor
Full Name
Angélus Hénok Sègla KOUTCHIKO
First Name Last Name

Email Address

henoksegla@gmail.com
Mobile number

0022995200297
Address

Abomey-Calavi/ Bénin
Address Line

05BP1753 Cotonou-Rep.Benin
Masters/PHD/Post-Doctorate

PHD
Name of degree/degree title
PhD in Physiology/Physiopathology/Molecular Pharmacology
Are you available for travel?

Yes
Yes No
Nationality

Beninese