CHRISTANNAH MARIE DOMIN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125051417

License Status

EXPIRED

Business

First Name

CHRISTANNAH

Middle

MARIE

Last Name

DOMIN

Suffix

Business Name

CHRISTANNAH MARIE DOMIN MD

Original Issue Date

07/01/2006

Effective Date

07/01/2006

Expiration Date

06/30/2009

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Obstetrics & Gynecology

Ever Disciplined

LastModifiedDate

07/15/2009