DOMINEE CRUZ MIRANDA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125054456

License Status

EXPIRED

Business

Title

First Name

DOMINEE

Middle

CRUZ

Last Name

MIRANDA

Business Name

DOMINEE CRUZ MIRANDA MD

Original Issue Date

07/01/2008

Effective Date

07/01/2008

Expiration Date

06/30/2011

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

07/19/2011