DOMINIQUE M LASH Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****62

License Status

NOT RENEWED

Business

First Name

DOMINIQUE

Middle

Last Name

LASH

Business Name

DOMINIQUE M LASH

Original Issue Date

03/22/2004

Effective Date

08/19/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011