LAWRENCE BLACK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049057103

License Status

NOT RENEWED

Business

First Name

LAWRENCE

Last Name

BLACK

Business Name

LAWRENCE BLACK

Original Issue Date

11/30/1971

Effective Date

11/30/1971

Expiration Date

01/01/1997

City

CALUMET CITY

State

Zip

60409

County

COOK

Ever Disciplined

LastModifiedDate

10/17/2005