ROBERTA DIANE BALLARD - Pharmacist License in Illinois | # 049054257

ROBERTA DIANE BALLARD

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049054257

License Status

NOT RENEWED

Business

N

First Name

ROBERTA DIANE

Last Name

BALLARD

Business Name

ROBERTA DIANE BALLARD

Original Issue Date

01/01/1997

Expiration Date

03/31/1984

State

IL

Ever Disciplined

N

LastModifiedDate

10/17/2005