DOMINIQUE L GARITI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****64

License Status

NOT RENEWED

Business

Title

First Name

DOMINIQUE

Middle

Last Name

GARITI

Business Name

DOMINIQUE L GARITI MD

Original Issue Date

03/18/2015

Effective Date

03/18/2015

Expiration Date

07/31/2017

City

GREENFIELD

State

Zip

53228

County

WISCONSIN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017