BRIAR WAYNE FORTKAMP Medical Cannabis Professional License verification

Business Entity

TERMINATED

License Type

Medical Cannabis Professional

Description

REGISTERED AGENT

License Number

DOAG085583

License Status

TERMINATED

Business

First Name

BRIAR

Middle

WAYNE

Last Name

FORTKAMP

Business Name

BRIAR WAYNE FORTKAMP

Original Issue Date

10/11/2019

Effective Date

10/11/2019

Expiration Date

10/11/2020

City

MARION

State

Zip

62959

Ever Disciplined

LastModifiedDate

10/09/2019