JOHANNA RENE BLACK - Pharmacist License in Illinois | # 049113391

JOHANNA RENE BLACK

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049113391

License Status

NOT RENEWED

Business

N

First Name

JOHANNA RENE

Last Name

BLACK

Business Name

JOHANNA RENE BLACK

Original Issue Date

02/14/1996

Effective Date

02/14/1996

Expiration Date

03/31/1997

State

IL

Ever Disciplined

N

LastModifiedDate

10/17/2005