DOMINQUE LATRICE MOORE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049261375

License Status

NOT RENEWED

Business

First Name

DOMINQUE

Middle

LATRICE

Last Name

MOORE

Business Name

DOMINQUE LATRICE MOORE

Original Issue Date

11/27/2018

Effective Date

03/20/2019

Expiration Date

09/30/2020

City

VALPARAISO

State

Zip

46385

Ever Disciplined

LastModifiedDate

10/22/2021