DOMINIQUE SIMONE SULLIVAN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049159251

License Status

NOT RENEWED

Business

First Name

DOMINIQUE

Middle

SIMONE

Last Name

SULLIVAN

Business Name

DOMINIQUE SIMONE SULLIVAN

Original Issue Date

02/15/2005

Effective Date

03/17/2009

Expiration Date

03/31/2010

City

CHICAGO

State

Zip

60617

County

COOK

Ever Disciplined

LastModifiedDate

05/04/2010