BRYANT KELLY FORTSON Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049106705

License Status

NOT RENEWED

Business

First Name

BRYANT KELLY

Last Name

FORTSON

Business Name

BRYANT KELLY FORTSON

Original Issue Date

04/26/1994

Effective Date

04/26/1994

Expiration Date

03/31/1996

City

CHICAGO

State

Zip

60653

County

COOK

Ever Disciplined

LastModifiedDate

10/17/2005