DOMINIQUE IRIS MATA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049221724

License Status

NOT RENEWED

Business

First Name

DOMINIQUE

Middle

IRIS

Last Name

MATA

Business Name

DOMINIQUE IRIS MATA

Original Issue Date

11/04/2013

Effective Date

11/04/2013

Expiration Date

03/31/2014

City

STREATOR

State

Zip

61364

Ever Disciplined

LastModifiedDate

05/06/2014