JOSE L DOMINGUEZ MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****82

NOT RENEWED

N

JOSE L

DOMINGUEZ

MD

JOSE L DOMINGUEZ MD

05/20/1992

05/20/1992

07/31/1993

CHICAGO

IL

60640

COOK

II III IV V

N

09/26/2006