DOMINIQUE BAZILE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036059282

License Status

NOT RENEWED

Business

First Name

DOMINIQUE

Last Name

BAZILE

Suffix

Business Name

DOMINIQUE BAZILE MD

Original Issue Date

08/27/1979

Effective Date

07/14/2017

Expiration Date

09/30/2020

City

BOLINGBROOK

State

Zip

60440

County

WILL

Ever Disciplined

LastModifiedDate

01/14/2021