DOMINIQUE JACOB SMITH MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036091181

License Status

INACTIVE

Business

First Name

DOMINIQUE JACOB

Last Name

SMITH

Suffix

Business Name

DOMINIQUE JACOB SMITH MD

Original Issue Date

07/05/1995

Effective Date

07/05/1995

Expiration Date

07/31/1996

City

OAK PARK

State

Zip

60302

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006