MARTIN E LASAK Pharmacist License verification

Business Entity

CANCELLED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049058128

License Status

CANCELLED

Business

First Name

MARTIN E

Last Name

LASAK

Business Name

MARTIN E LASAK

Original Issue Date

07/21/1972

Effective Date

07/21/1972

Expiration Date

01/01/1997

City

CHICAGO

State

Zip

60641

County

COOK

Ever Disciplined

LastModifiedDate

10/17/2005