MARY ANN R DOMINGO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125034451

License Status

EXPIRED

Business

First Name

MARY ANN

Middle

Last Name

DOMINGO

Business Name

MARY ANN R DOMINGO

Original Issue Date

05/20/1996

Effective Date

05/20/1996

Expiration Date

06/30/1999

City

CHICAGO

State

Zip

60616

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006