MINERVA T DOMINGO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****33

License Status

NOT RENEWED

Business

First Name

MINERVA T

Last Name

DOMINGO

Suffix

Business Name

MINERVA T DOMINGO MD

Original Issue Date

03/11/1996

Effective Date

03/11/1996

Expiration Date

07/31/1999

City

CENTRALIA

State

Zip

62801

County

CLINTON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006