BURT DAVID GOLTZ Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049057646

License Status

NOT RENEWED

Business

First Name

BURT DAVID

Last Name

GOLTZ

Business Name

BURT DAVID GOLTZ

Original Issue Date

05/02/1972

Effective Date

05/02/1972

Expiration Date

01/01/1997

City

CHICAGO

State

Zip

60626

County

COOK

Ever Disciplined

LastModifiedDate

10/17/2005