NOEL EUSTAQUIO SANTO DOMINGO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036087736

License Status

NOT RENEWED

Business

First Name

NOEL EUSTAQUIO

Last Name

SANTO DOMINGO

Suffix

Business Name

NOEL EUSTAQUIO SANTO DOMINGO MD

Original Issue Date

11/05/1993

Effective Date

11/05/1993

Expiration Date

07/31/1996

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

04/27/2010