LUIS MANUEL VIVEROS-BALDERAS Medical Cannabis Professional License verification

Business Entity

TERMINATED

License Type

Medical Cannabis Professional

Description

REGISTERED AGENT-IN-CHARGE

License Number

DOAC029617

License Status

TERMINATED

Business

First Name

LUIS

Middle

MANUEL

Last Name

VIVEROS-BALDERAS

Business Name

LUIS MANUEL VIVEROS-BALDERAS

Original Issue Date

11/15/2019

Effective Date

11/16/2021

Expiration Date

11/15/2022

City

MONMOUTH

State

Zip

61462

County

WARREN

Ever Disciplined

LastModifiedDate

10/25/2021