KEVIN R BLACK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049060936

License Status

NOT RENEWED

Business

First Name

KEVIN R

Last Name

BLACK

Business Name

KEVIN R BLACK

Original Issue Date

02/11/1974

Effective Date

02/11/1974

Expiration Date

01/01/1997

City

CHICAGO

State

Zip

60641

County

COOK

Ever Disciplined

LastModifiedDate

10/17/2005