STEPHANIE MICHELLE DOMINIQUE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049118164

License Status

NOT RENEWED

Business

First Name

STEPHANIE

Middle

MICHELLE

Last Name

DOMINIQUE

Business Name

STEPHANIE MICHELLE DOMINIQUE

Original Issue Date

07/17/1997

Effective Date

07/17/1997

Expiration Date

03/31/2000

City

GALESBURG

State

Zip

61401

County

KNOX

Ever Disciplined

LastModifiedDate

10/21/2005