DERRICK N BURGESS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049096269

License Status

NOT RENEWED

Business

First Name

DERRICK N

Last Name

BURGESS

Business Name

DERRICK N BURGESS

Original Issue Date

03/26/1991

Effective Date

03/26/1991

Expiration Date

03/31/1994

City

CHICAGO

State

Zip

60619

County

COOK

Ever Disciplined

LastModifiedDate

10/17/2005