THERESE M MODRAK - Pharmacist License in Indiana | # 049095171

THERESE M MODRAK

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049095171

License Status

NOT RENEWED

Business

N

First Name

THERESE M

Last Name

MODRAK

Business Name

THERESE M MODRAK

Original Issue Date

12/01/1990

Effective Date

12/01/1990

Expiration Date

03/31/1992

State

IN

Ever Disciplined

N

LastModifiedDate

10/17/2005