DANIEL FORTMAN - Pharmacist License in Illinois | # 049067569

DANIEL FORTMAN

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049067569

License Status

NOT RENEWED

Business

N

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

State

IL

Ever Disciplined

N

LastModifiedDate

10/17/2005