DAVID J DOMIN Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125015119

License Status

EXPIRED

Business

First Name

DAVID

Middle

Last Name

DOMIN

Business Name

DAVID J DOMIN

Original Issue Date

01/21/1983

Effective Date

01/21/1983

Expiration Date

01/02/1985

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

09/22/2006