PHYLLIS D DOMENA - Pharmacist License in Illinois | # 049243035

PHYLLIS D DOMENA

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049243035

License Status

NOT RENEWED

Business

N

First Name

PHYLLIS

Middle

D

Last Name

DOMENA

Business Name

PHYLLIS D DOMENA

Original Issue Date

07/08/2016

Effective Date

07/08/2016

Expiration Date

03/31/2017

State

IL

Ever Disciplined

N

LastModifiedDate

05/10/2017