DERRICK DWAYNE BULLOCK - Pharmacist License in Illinois | # 049075138

DERRICK DWAYNE BULLOCK

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049075138

License Status

NOT RENEWED

Business

N

First Name

DERRICK DWAYNE

Last Name

BULLOCK

Business Name

DERRICK DWAYNE BULLOCK

Original Issue Date

08/17/1981

Effective Date

08/17/1981

Expiration Date

03/31/1984

State

IL

Ever Disciplined

N

LastModifiedDate

10/17/2005