DOMINIQUE JOHNSON DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****14

License Status

ACTIVE

Business

Title

First Name

DOMINIQUE

Last Name

JOHNSON

Business Name

DOMINIQUE JOHNSON DO

Original Issue Date

08/30/2024

Effective Date

08/30/2024

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60619

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/30/2024