DAXA D MODI Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049092254

License Status

NOT RENEWED

Business

First Name

DAXA D

Last Name

MODI

Business Name

DAXA D MODI

Original Issue Date

04/24/1990

Effective Date

04/24/1990

Expiration Date

03/31/1994

City

CHICAGO

State

Zip

60625

County

COOK

Ever Disciplined

LastModifiedDate

10/17/2005