MICHELLE A DOMIN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049171802

License Status

NOT RENEWED

Business

First Name

MICHELLE

Middle

Last Name

DOMIN

Business Name

MICHELLE A DOMIN

Original Issue Date

10/05/2006

Effective Date

10/05/2006

Expiration Date

03/31/2007

City

BERWYN

State

Zip

60402

County

COOK

Ever Disciplined

LastModifiedDate

05/14/2007