DOMINIQUE ANCIAUX Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036086049

License Status

NOT RENEWED

Business

First Name

DOMINIQUE

Last Name

ANCIAUX

Business Name

DOMINIQUE ANCIAUX

Original Issue Date

05/17/1993

Effective Date

05/17/1993

Expiration Date

07/31/1996

City

CHICAGO

State

Zip

60613

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006