ANA C DOMINGUES Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****98

License Status

NOT RENEWED

Business

First Name

ANA

Middle

Last Name

DOMINGUES

Business Name

ANA C DOMINGUES

Original Issue Date

08/22/2000

Effective Date

08/22/2000

Expiration Date

07/31/2005

City

CICERO

State

Zip

60804

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006