TYSA SUZANNE FUNDEL - Pharmacist License in Illinois | # 049062191

TYSA SUZANNE FUNDEL

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049062191

License Status

NOT RENEWED

Business

N

First Name

TYSA SUZANNE

Last Name

FUNDEL

Business Name

TYSA SUZANNE FUNDEL

Original Issue Date

09/06/1974

Effective Date

09/06/1974

Expiration Date

01/01/1997

State

IL

Ever Disciplined

N

LastModifiedDate

10/17/2005