PAM TIFFANY PUA CAPULONG - Pharmacist License in Illinois | # 049208525

PAM TIFFANY PUA CAPULONG

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049208525

License Status

NOT RENEWED

Business

N

First Name

PAM TIFFANY

Middle

PUA

Last Name

CAPULONG

Business Name

PAM TIFFANY PUA CAPULONG

Original Issue Date

01/03/2012

Effective Date

03/04/2013

Expiration Date

03/31/2014

State

IL

Ever Disciplined

N

LastModifiedDate

05/06/2014