DOMINIC OMAR ANSARI MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125059098

License Status

EXPIRED

Business

First Name

DOMINIC

Middle

OMAR

Last Name

ANSARI

Suffix

Business Name

DOMINIC OMAR ANSARI MD

Original Issue Date

06/24/2011

Effective Date

06/24/2011

Expiration Date

06/23/2014

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

03/13/2015