DWAYNE E LACEY Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049101177

License Status

NOT RENEWED

Business

First Name

DWAYNE E

Last Name

LACEY

Business Name

DWAYNE E LACEY

Original Issue Date

09/03/1992

Effective Date

09/03/1992

Expiration Date

03/31/1995

City

FOREST PARK

State

Zip

60130

County

COOK

Ever Disciplined

LastModifiedDate

10/17/2005