FREDERICA BROADNAX Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049059514

License Status

NOT RENEWED

Business

First Name

FREDERICA

Last Name

BROADNAX

Business Name

FREDERICA BROADNAX

Original Issue Date

05/18/1973

Effective Date

05/18/1973

Expiration Date

01/01/1997

City

CHICAGO

State

Zip

60617

County

COOK

Ever Disciplined

LastModifiedDate

10/17/2005