DOMINICK DETOMMASO Podiatrist License verification

Business Entity

INACTIVE

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016002962

License Status

INACTIVE

Business

First Name

DOMINICK

Last Name

DETOMMASO

Business Name

DOMINICK DETOMMASO

Original Issue Date

08/03/1977

Effective Date

08/03/1977

Expiration Date

01/31/1989

City

FORT WAYNE

State

Zip

46807

County

INDIANA

Ever Disciplined

LastModifiedDate

09/25/2006