THOMAS J BALLOG Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049066512

License Status

NOT RENEWED

Business

First Name

THOMAS J

Last Name

BALLOG

Business Name

THOMAS J BALLOG

Original Issue Date

12/10/1976

Effective Date

12/10/1976

Expiration Date

01/01/1997

City

RIVERTON

State

Zip

62561

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/17/2005