JAN R GROENEWOLD Pharmacist License verification

Business Entity

CANCELLED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049063788

License Status

CANCELLED

Business

First Name

JAN R

Last Name

GROENEWOLD

Business Name

JAN R GROENEWOLD

Original Issue Date

06/27/1975

Effective Date

06/27/1975

Expiration Date

01/01/1997

City

ORLAND PARK

State

Zip

60462

County

COOK

Ever Disciplined

LastModifiedDate

10/17/2005