CAROLYN R BALTAZAR Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049092468

License Status

NOT RENEWED

Business

First Name

CAROLYN R

Last Name

BALTAZAR

Business Name

CAROLYN R BALTAZAR

Original Issue Date

03/17/1990

Effective Date

03/10/2010

Expiration Date

03/31/2011

City

CHICAGO

State

Zip

60638

County

COOK

Ever Disciplined

LastModifiedDate

05/12/2011