SUSAN M FOG Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049057558

License Status

NOT RENEWED

Business

First Name

SUSAN M

Last Name

FOG

Business Name

SUSAN M FOG

Original Issue Date

04/01/1972

Effective Date

04/01/1972

Expiration Date

01/01/1997

City

CARPENTERSVILLE

State

Zip

60110

County

KANE

Ever Disciplined

LastModifiedDate

10/17/2005