MARISELA DOMINGUEZ Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125029662

License Status

EXPIRED

Business

First Name

MARISELA

Last Name

DOMINGUEZ

Business Name

MARISELA DOMINGUEZ

Original Issue Date

05/15/1993

Effective Date

05/15/1993

Expiration Date

06/30/1996

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Addiction Psychiatry

Ever Disciplined

LastModifiedDate

09/22/2006