EDMUNDO G DELA PROVIDENCIA - Pharmacist License in Illinois | # 049161801

EDMUNDO G DELA PROVIDENCIA

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049161801

License Status

NOT RENEWED

Business

N

First Name

EDMUNDO

Middle

G

Last Name

DELA PROVIDENCIA

Business Name

EDMUNDO G DELA PROVIDENCIA

Original Issue Date

06/21/2005

Effective Date

04/15/2015

Expiration Date

03/31/2016

State

IL

Ever Disciplined

N

LastModifiedDate

05/20/2016