WAYNE R DOMIN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049063020

License Status

NOT RENEWED

Business

First Name

WAYNE R

Last Name

DOMIN

Business Name

WAYNE R DOMIN

Original Issue Date

02/28/1975

Effective Date

02/28/1975

Expiration Date

01/01/1997

City

BERWYN

State

Zip

60402

County

COOK

Ever Disciplined

LastModifiedDate

10/17/2005