RANDOLPH JOHN KOUBA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049058723

License Status

NOT RENEWED

Business

First Name

RANDOLPH JOHN

Last Name

KOUBA

Business Name

RANDOLPH JOHN KOUBA

Original Issue Date

11/18/1972

Effective Date

11/18/1972

Expiration Date

01/01/1997

City

WAUKEGAN

State

Zip

60085

County

LAKE

Ever Disciplined

LastModifiedDate

10/17/2005