DANIEL FORMOSA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049073552

License Status

NOT RENEWED

Business

First Name

DANIEL

Last Name

FORMOSA

Business Name

DANIEL FORMOSA

Original Issue Date

09/05/1980

Effective Date

09/05/1980

Expiration Date

03/31/1984

City

OAK LAWN

State

Zip

60453

County

COOK

Ever Disciplined

LastModifiedDate

10/17/2005