DAYANA MARLEN DOMINGUEZ BATISTA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125073222

License Status

CANCELLED

Business

Title

First Name

DAYANA

Middle

MARLEN

Last Name

DOMINGUEZ BATISTA

Business Name

DAYANA MARLEN DOMINGUEZ BATISTA MD

Original Issue Date

07/01/2018

Effective Date

07/01/2018

Expiration Date

06/30/2021

City

SAINT LOUIS

State

Zip

63108

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

06/19/2018