VIRGINIA G DOMINGUEZ-MATSUMOTO DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****26

License Status

ACTIVE

Business

First Name

VIRGINIA G

Last Name

DOMINGUEZ-MATSUMOTO

Suffix

DDS

Business Name

VIRGINIA G DOMINGUEZ-MATSUMOTO DDS

Original Issue Date

12/19/1989

Effective Date

09/06/2024

Expiration Date

09/30/2027

City

ELMWOOD PARK

State

Zip

60707

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/06/2024