JUDITH M FORNESS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049105186

License Status

NOT RENEWED

Business

First Name

JUDITH M

Last Name

FORNESS

Business Name

JUDITH M FORNESS

Original Issue Date

11/09/1993

Effective Date

01/10/2008

Expiration Date

03/31/2009

City

MACOMB

State

Zip

61455

County

MCDONOUGH

Ever Disciplined

LastModifiedDate

05/06/2009