TATIANA RAMIREZ DOMINGUEZ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****07

License Status

NOT RENEWED

Business

Title

First Name

TATIANA

Last Name

RAMIREZ DOMINGUEZ

Business Name

TATIANA RAMIREZ DOMINGUEZ MD

Original Issue Date

08/28/2015

Effective Date

04/11/2017

Expiration Date

09/30/2020

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021