HAZEL DHATES DOMINGO Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085007019

License Status

ACTIVE

Business

First Name

HAZEL

Middle

DHATES

Last Name

DOMINGO

Business Name

HAZEL DHATES DOMINGO

Original Issue Date

03/29/2019

Effective Date

02/27/2026

Expiration Date

03/01/2028

City

CHICAGO

State

Zip

60618

Ever Disciplined

LastModifiedDate

02/27/2026