ANN E DOMINGUEZ Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125035955

License Status

EXPIRED

Business

First Name

ANN

Middle

Last Name

DOMINGUEZ

Business Name

ANN E DOMINGUEZ

Original Issue Date

05/12/1997

Effective Date

05/12/1997

Expiration Date

06/18/2000

City

RIVER FOREST

State

Zip

60305

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006