ANN E DOMINGUEZ Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036100918

License Status

NOT RENEWED

Business

First Name

ANN

Middle

Last Name

DOMINGUEZ

Business Name

ANN E DOMINGUEZ

Original Issue Date

08/06/1999

Effective Date

08/06/1999

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60623

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006