RAFAEL ROBERTO DOMINGUEZ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****38

License Status

NOT RENEWED

Business

First Name

RAFAEL

Middle

ROBERTO

Last Name

DOMINGUEZ

Suffix

Business Name

RAFAEL ROBERTO DOMINGUEZ MD

Original Issue Date

04/28/2005

Effective Date

06/10/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60622

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020