DOMINIQUE JACOB SMITH MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125028604

License Status

EXPIRED

Business

First Name

DOMINIQUE JACOB

Last Name

SMITH

Suffix

Business Name

DOMINIQUE JACOB SMITH MD

Original Issue Date

06/04/1992

Effective Date

06/04/1992

Expiration Date

06/30/1995

City

CHICAGO

State

Zip

60614

County

COOK

Specialty/Qualifier

Obstetrics & Gynecology

Ever Disciplined

LastModifiedDate

09/22/2006