DOMINIQUE M PATTHANACHAROENPHON Pharmacist License verification

Business Entity

INACTIVE

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051289748

License Status

INACTIVE

Business

First Name

DOMINIQUE

Middle

Last Name

PATTHANACHAROENPHON

Business Name

DOMINIQUE M PATTHANACHAROENPHON

Original Issue Date

11/07/2003

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

03/09/2010