DONALD STEVEN PROVENZANO Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049056635

License Status

NOT RENEWED

Business

First Name

DONALD STEVEN

Last Name

PROVENZANO

Business Name

DONALD STEVEN PROVENZANO

Original Issue Date

01/01/1997

Expiration Date

01/01/1997

City

BLOOMINGDALE

State

Zip

60108

County

DUPAGE

Ever Disciplined

LastModifiedDate

10/17/2005