TRAVIS D FULLERTON - Pharmacist License in Illinois | # 049099023

TRAVIS D FULLERTON

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049099023

License Status

NOT RENEWED

Business

N

First Name

TRAVIS D

Last Name

FULLERTON

Business Name

TRAVIS D FULLERTON

Original Issue Date

12/30/1991

Effective Date

12/30/1991

Expiration Date

03/31/1998

State

IL

Ever Disciplined

N

LastModifiedDate

10/17/2005