MICHELLE DOMINGO CORRALES MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****72

License Status

NOT RENEWED

Business

First Name

MICHELLE

Middle

DOMINGO

Last Name

CORRALES

Suffix

Business Name

MICHELLE DOMINGO CORRALES MD

Original Issue Date

05/10/2007

Effective Date

05/10/2007

Expiration Date

07/31/2008

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008