THERESA MAE DIERCKMAN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049060391

License Status

NOT RENEWED

Business

First Name

THERESA MAE

Last Name

DIERCKMAN

Business Name

THERESA MAE DIERCKMAN

Original Issue Date

10/15/1973

Effective Date

10/15/1973

Expiration Date

01/01/1997

City

CHICAGO

State

Zip

60637

County

COOK

Ever Disciplined

LastModifiedDate

10/17/2005