ALFONSO ALLAN BALLEZA II - Pharmacist License in Illinois | # 049153041

ALFONSO ALLAN BALLEZA II

Business Entity

INACTIVE

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049153041

License Status

INACTIVE

Business

N

First Name

ALFONSO

Middle

ALLAN

Last Name

BALLEZA

Suffix

II

Business Name

ALFONSO ALLAN BALLEZA II

Original Issue Date

01/29/2004

Effective Date

03/24/2011

Expiration Date

03/31/2012

State

IL

Ever Disciplined

N

LastModifiedDate

01/12/2012