IVY NICOLE BRANTLEY - Pharmacist License in Illinois | # 049115464

IVY NICOLE BRANTLEY

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049115464

License Status

NOT RENEWED

Business

N

First Name

IVY NICOLE

Last Name

BRANTLEY

Business Name

IVY NICOLE BRANTLEY

Original Issue Date

10/02/1996

Effective Date

10/02/1996

Expiration Date

03/31/1997

State

IL

Ever Disciplined

N

LastModifiedDate

10/17/2005