Pharmacist
PHARMACY TECHNICIAN
049092539
NOT RENEWED
N
LATEEFUNNISA
MOHAMMED
LATEEFUNNISA MOHAMMED
03/14/1990
10/17/2012
03/31/2013
HANOVER PARK
IL
60133
COOK
Y
05/06/2013
1997050016
Refuse To Renew
05/08/1997
06/13/1997
More than 30 days delinquent in the payment of child support.