DANA M SUPRENANT Pharmacist License verification

Business Entity

INACTIVE

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049074346

License Status

INACTIVE

Business

First Name

DANA M

Last Name

SUPRENANT

Business Name

DANA M SUPRENANT

Original Issue Date

03/16/1981

Effective Date

03/03/2011

Expiration Date

03/31/2012

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Ever Disciplined

LastModifiedDate

01/12/2012