DOMINIQUE M PATTHANACHAROENPHON Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049151263

License Status

NOT RENEWED

Business

First Name

DOMINIQUE

Middle

Last Name

PATTHANACHAROENPHON

Business Name

DOMINIQUE M PATTHANACHAROENPHON

Original Issue Date

10/02/2003

Effective Date

10/02/2003

Expiration Date

03/31/2004

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

10/20/2005