DOUGLAS ERIC SAMUELSON Pharmacist License verification

Business Entity

CANCELLED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049071562

License Status

CANCELLED

Business

First Name

DOUGLAS ERIC

Last Name

SAMUELSON

Business Name

DOUGLAS ERIC SAMUELSON

Original Issue Date

07/13/1979

Effective Date

07/13/1979

Expiration Date

03/31/1984

City

LOMBARD

State

Zip

60148

County

DUPAGE

Ever Disciplined

LastModifiedDate

10/17/2005