CARMINA AMOR TAN DOMINGO DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****70

License Status

ACTIVE

Business

Title

First Name

CARMINA

Middle

AMOR TAN

Last Name

DOMINGO

Business Name

CARMINA AMOR TAN DOMINGO DO

Original Issue Date

02/09/2022

Effective Date

07/06/2023

Expiration Date

07/31/2026

City

NAPERVILLE

State

Zip

60564

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/06/2023