ERIC W FORTMAN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049078550

License Status

NOT RENEWED

Business

First Name

ERIC W

Last Name

FORTMAN

Business Name

ERIC W FORTMAN

Original Issue Date

07/08/1983

Effective Date

07/08/1983

Expiration Date

03/31/2001

City

VERNON HILLS

State

Zip

60061

County

LAKE

Ever Disciplined

LastModifiedDate

10/21/2005