DIANE L DOMAS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049162984

License Status

NOT RENEWED

Business

First Name

DIANE

Middle

Last Name

DOMAS

Business Name

DIANE L DOMAS

Original Issue Date

08/15/2005

Effective Date

08/15/2005

Expiration Date

03/31/2006

City

CHICAGO

State

Zip

60614

County

COOK

Ever Disciplined

LastModifiedDate

05/11/2006