DAVID F DIDOMENICO MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****92

License Status

ACTIVE

Business

Title

First Name

DAVID

Middle

Last Name

DIDOMENICO

Business Name

DAVID F DIDOMENICO MD

Original Issue Date

05/17/1994

Effective Date

04/13/2023

Expiration Date

07/31/2026

City

MATTOON

State

Zip

61938

County

COLES

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/13/2023