MARK E DOMAAS DPM Podiatrist License verification

Business Entity

CANCELLED

License Type

Podiatrist

Description

TEMPORARY PODIATRIC PHYSICIAN

License Number

135000830

License Status

CANCELLED

Business

Title

DPM

First Name

MARK

Middle

Last Name

DOMAAS

Business Name

MARK E DOMAAS DPM

Original Issue Date

05/08/2014

Effective Date

07/01/2015

Expiration Date

06/30/2016

City

CHICAGO

State

Zip

60608

County

COOK

Ever Disciplined

LastModifiedDate

05/08/2014