BLAYNE FULLEM Medical Cannabis Professional License verification

Business Entity

TERMINATED

License Type

Medical Cannabis Professional

Description

REGISTERED AGENT

License Number

DOAG408453

License Status

TERMINATED

Business

First Name

BLAYNE

Last Name

FULLEM

Business Name

BLAYNE FULLEM

Original Issue Date

01/11/2019

Effective Date

01/12/2023

Expiration Date

01/11/2024

City

OFALLON

State

Zip

62269

Ever Disciplined

LastModifiedDate

01/11/2024