RAFAEL ROBERTO DOMINGUEZ 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

First Name

RAFAEL

Middle

ROBERTO

Last Name

DOMINGUEZ

Suffix

Business Name

RAFAEL ROBERTO DOMINGUEZ MD

Original Issue Date

07/07/2005

Effective Date

06/24/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60660

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/24/2023