DOMINGO J DELAFUENTE 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

DOMINGO J

Last Name

DELAFUENTE

Suffix

Business Name

DOMINGO J DELAFUENTE MD

Original Issue Date

07/10/1981

Effective Date

06/15/2011

Expiration Date

07/31/2014

City

NORTHBROOK

State

Zip

60062

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014