MANUEL G DOMINGUEZ JR MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125027056

License Status

EXPIRED

Business

Title

First Name

MANUEL

Middle

Last Name

DOMINGUEZ JR

Business Name

MANUEL G DOMINGUEZ JR MD

Original Issue Date

06/04/1991

Effective Date

06/04/1991

Expiration Date

06/30/1994

City

CHICAGO

State

Zip

60622

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006