JOSE M DOMINGUEZ MD 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

JOSE M

Last Name

DOMINGUEZ

Suffix

Business Name

JOSE M DOMINGUEZ MD

Original Issue Date

06/16/1992

Effective Date

06/16/1992

Expiration Date

07/31/1996

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006