DON ROSS DOMENICO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****54

License Status

NOT RENEWED

Business

Title

First Name

DON

Middle

ROSS

Last Name

DOMENICO

Business Name

DON ROSS DOMENICO MD

Original Issue Date

10/12/1982

Effective Date

10/12/1982

Expiration Date

07/31/1987

City

CARBONDALE

State

Zip

62901

County

JACKSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2017