MICHAEL LASALLE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049071544

License Status

NOT RENEWED

Business

First Name

MICHAEL

Last Name

LASALLE

Business Name

MICHAEL LASALLE

Original Issue Date

07/13/1979

Effective Date

07/13/1979

Expiration Date

01/01/1997

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/17/2005