BRIAN VAN VICKLE - Pharmacist License in Illinois | # 097001810

BRIAN VAN VICKLE

Business Entity

CANCELLED

License Type

Pharmacist

Description

OTHER CONTROLLED SUBSTANCE

License Number

097001810

License Status

CANCELLED

Business

Y

Business Name

BRIAN VAN VICKLE

State

IL

Specialty/Qualifier

GOVT-LOCAL

Controlled Substance Schedule

I II

Ever Disciplined

N

LastModifiedDate

09/08/2011