RUTH DOMAZET TANGONAN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125072214

License Status

CANCELLED

Business

Title

First Name

RUTH

Middle

DOMAZET

Last Name

TANGONAN

Business Name

RUTH DOMAZET TANGONAN MD

Original Issue Date

07/01/2021

Effective Date

07/01/2021

Expiration Date

06/30/2022

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Neurology

Ever Disciplined

LastModifiedDate

01/21/2021