DIANA L BERGMAN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049058231

License Status

NOT RENEWED

Business

First Name

DIANA L

Last Name

BERGMAN

Business Name

DIANA L BERGMAN

Original Issue Date

08/22/1972

Effective Date

08/22/1972

Expiration Date

01/01/1997

City

NORTHLAKE

State

Zip

60164

County

COOK

Ever Disciplined

LastModifiedDate

10/17/2005