NOEL EUSTAQUIO SANTO DOMINGO MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125026977

License Status

EXPIRED

Business

First Name

NOEL EUSTAQUIO

Last Name

SANTO DOMINGO

Suffix

Business Name

NOEL EUSTAQUIO SANTO DOMINGO MD

Original Issue Date

05/28/1991

Effective Date

05/28/1991

Expiration Date

06/23/1994

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006