PAUL DOUGLAS FOG Pharmacist License verification

Business Entity

CANCELLED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049064091

License Status

CANCELLED

Business

First Name

PAUL DOUGLAS

Last Name

FOG

Business Name

PAUL DOUGLAS FOG

Original Issue Date

08/29/1975

Effective Date

08/29/1975

Expiration Date

01/01/1997

City

OSWEGO

State

Zip

60543

County

KENDALL

Ever Disciplined

LastModifiedDate

10/17/2005