ANDREA SOUTHALL Pharmacist License verification

Business Entity

CANCELLED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049072520

License Status

CANCELLED

Business

First Name

ANDREA

Last Name

SOUTHALL

Business Name

ANDREA SOUTHALL

Original Issue Date

02/08/1980

Effective Date

02/08/1980

Expiration Date

01/01/1997

City

CHICAGO HEIGHTS

State

Zip

60411

County

COOK

Ever Disciplined

LastModifiedDate

10/17/2005