DOMINADOR T MARTIN JR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****48

License Status

NOT RENEWED

Business

First Name

DOMINADOR T

Last Name

MARTIN JR

Suffix

Business Name

DOMINADOR T MARTIN JR MD

Original Issue Date

01/01/1997

Effective Date

07/28/2011

Expiration Date

07/31/2014

City

DANVILLE

State

Zip

61832

County

VERMILION

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014