MARISELA DOMINGUEZ Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036091349

License Status

NOT RENEWED

Business

First Name

MARISELA

Last Name

DOMINGUEZ

Business Name

MARISELA DOMINGUEZ

Original Issue Date

07/20/1995

Effective Date

06/10/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60645

County

COOK

Ever Disciplined

LastModifiedDate

11/14/2011