KIEFER PROVOST Medical Cannabis Professional License verification

Business Entity

TERMINATED

License Type

Medical Cannabis Professional

Description

REGISTERED AGENT

License Number

DOAG208217

License Status

TERMINATED

Business

First Name

KIEFER

Last Name

PROVOST

Business Name

KIEFER PROVOST

Original Issue Date

06/10/2024

Effective Date

06/10/2025

Expiration Date

06/10/2026

City

LOVES PARK

State

Zip

61111

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

12/02/2025