JULIE DIANE FORTIN Medical Cannabis Professional License verification

Business Entity

TERMINATED

License Type

Medical Cannabis Professional

Description

REGISTERED AGENT

License Number

DOAG956669

License Status

TERMINATED

Business

First Name

JULIE

Middle

DIANE

Last Name

FORTIN

Business Name

JULIE DIANE FORTIN

Original Issue Date

05/04/2016

Effective Date

05/04/2016

Expiration Date

05/04/2017

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Ever Disciplined

LastModifiedDate

08/23/2016