AVI ELIZABETH DOMNITZ GEBET DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****18

License Status

NOT RENEWED

Business

Title

First Name

AVI

Middle

ELIZABETH

Last Name

DOMNITZ GEBET

Business Name

AVI ELIZABETH DOMNITZ GEBET DO

Original Issue Date

01/16/2015

Effective Date

08/02/2017

Expiration Date

09/30/2020

City

CHERRY VALLEY

State

Zip

61016

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021