NATALIE NICOLE DOMEK DPM Podiatrist License verification

Business Entity

CANCELLED

License Type

Podiatrist

Description

TEMPORARY PODIATRIC PHYSICIAN

License Number

135000769

License Status

CANCELLED

Business

Title

DPM

First Name

NATALIE

Middle

NICOLE

Last Name

DOMEK

Business Name

NATALIE NICOLE DOMEK DPM

Original Issue Date

06/06/2012

Effective Date

07/01/2013

Expiration Date

06/30/2014

City

MAYWOOD

State

Zip

60153

County

COOK

Ever Disciplined

LastModifiedDate

03/13/2015