ANTHONY A PROVENZANO Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049088748

License Status

NOT RENEWED

Business

First Name

ANTHONY A

Last Name

PROVENZANO

Business Name

ANTHONY A PROVENZANO

Original Issue Date

01/19/1989

Effective Date

01/19/1989

Expiration Date

03/31/1993

City

OAK LAWN

State

Zip

60453

County

COOK

Ever Disciplined

LastModifiedDate

10/17/2005