DOMINIC COSTABILE DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125017220

License Status

EXPIRED

Business

First Name

DOMINIC

Last Name

COSTABILE

Suffix

Business Name

DOMINIC COSTABILE DO

Original Issue Date

06/22/1984

Effective Date

06/22/1984

Expiration Date

07/01/1986

City

CHICAGO

State

Zip

60615

County

COOK

Specialty/Qualifier

Family Practice & OMT

Ever Disciplined

LastModifiedDate

09/22/2006