DOMENICO ASCENZIO JOHN FARINA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125068463

License Status

CANCELLED

Business

Title

First Name

DOMENICO

Middle

ASCENZIO JOHN

Last Name

FARINA

Business Name

DOMENICO ASCENZIO JOHN FARINA MD

Original Issue Date

06/23/2016

Effective Date

06/23/2016

Expiration Date

06/22/2019

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/16/2016