DON ROSS DOMENICO MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036064857

License Status

INACTIVE

Business

Title

First Name

DON

Middle

ROSS

Last Name

DOMENICO

Business Name

DON ROSS DOMENICO MD

Original Issue Date

07/23/1982

Effective Date

07/29/2014

Expiration Date

07/31/2017

City

CARBONDALE

State

Zip

62901

County

JACKSON

Ever Disciplined

LastModifiedDate

04/12/2017