DANIEL FORMOSA - Pharmacist License in Illinois | # 049073552

DANIEL FORMOSA

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049073552

License Status

NOT RENEWED

Business

N

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

State

IL

Ever Disciplined

N

LastModifiedDate

10/17/2005