PHYLLIS D DOMENA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049243035

License Status

NOT RENEWED

Business

First Name

PHYLLIS

Middle

Last Name

DOMENA

Business Name

PHYLLIS D DOMENA

Original Issue Date

07/08/2016

Effective Date

07/08/2016

Expiration Date

03/31/2017

City

BATAVIA

State

Zip

60510

County

KANE

Ever Disciplined

LastModifiedDate

05/10/2017