BRIAN J BAUTISTA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049111697

License Status

NOT RENEWED

Business

First Name

BRIAN

Middle

Last Name

BAUTISTA

Business Name

BRIAN J BAUTISTA

Original Issue Date

09/12/1995

Effective Date

09/12/1995

Expiration Date

03/31/2000

City

HANOVER PARK

State

Zip

60103

County

COOK

Ever Disciplined

LastModifiedDate

10/21/2005