DOUGLASS TAKASHI DOMOTO MD
Licensed Physician Controlled Substance
Illinois 336022042 Canceled
This Illinois license was held by DOUGLASS TAKASHI DOMOTO MD. The license is no longer active. It was granted on 01/01/1997 and expired on 07/31/2005
LICENSE DETAILS
- License Number: 336022042
- Category: LICENSED PHYSICIAN CONTROLLED SUBSTANCE
- Status: Canceled
- Date Granted: 01/01/1997 (over 27 years ago)
- Expiry Date: 07/31/2005 (over 18 years ago)
LOCATIONS
A Address
EAST SAINT LOUIS, IL 62201