JEROME TAYMON DOMZALSKI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036164444

License Status

ACTIVE

Business

Title

First Name

JEROME

Middle

TAYMON

Last Name

DOMZALSKI

Business Name

JEROME TAYMON DOMZALSKI MD

Original Issue Date

04/19/2023

Effective Date

04/19/2023

Expiration Date

07/31/2026

City

EAST PEORIA

State

Zip

61611

County

TAZEWELL

Ever Disciplined

LastModifiedDate

04/05/2023