DANIEL FORTMAN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049067569

License Status

NOT RENEWED

Business

First Name

DANIEL

Last Name

FORTMAN

Business Name

DANIEL FORTMAN

Original Issue Date

06/24/1977

Effective Date

06/24/1977

Expiration Date

03/31/1982

City

NORRIDGE

State

Zip

60656

County

COOK

Ever Disciplined

LastModifiedDate

10/17/2005