STACEY ELLEN BAN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049106776

License Status

NOT RENEWED

Business

First Name

STACEY

Middle

ELLEN

Last Name

BAN

Business Name

STACEY ELLEN BAN

Original Issue Date

05/03/1994

Effective Date

05/03/1994

Expiration Date

03/31/1995

City

DEERFIELD

State

Zip

60015

County

LAKE

Ever Disciplined

LastModifiedDate

10/17/2005