BETULIO DAVID DOMINGUEZ Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049159234

License Status

NOT RENEWED

Business

First Name

BETULIO

Middle

DAVID

Last Name

DOMINGUEZ

Business Name

BETULIO DAVID DOMINGUEZ

Original Issue Date

02/14/2005

Effective Date

02/14/2005

Expiration Date

03/31/2006

City

CHICAGO

State

Zip

60639

County

COOK

Ever Disciplined

LastModifiedDate

07/19/2007