GERARD DOMINIQUE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****49

License Status

NOT RENEWED

Business

First Name

GERARD

Last Name

DOMINIQUE

Suffix

Business Name

GERARD DOMINIQUE MD

Original Issue Date

01/01/1997

Expiration Date

07/31/2005

City

WOODSTOCK

State

Zip

60098

County

MCHENRY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006