ROBERTA POLIVKA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049061044

License Status

NOT RENEWED

Business

First Name

ROBERTA

Last Name

POLIVKA

Business Name

ROBERTA POLIVKA

Original Issue Date

02/22/1974

Effective Date

02/22/1974

Expiration Date

01/01/1997

City

FOREST PARK

State

Zip

60130

County

COOK

Ever Disciplined

LastModifiedDate

10/17/2005