BRIAN J BAUTISTA - Pharmacist License in Illinois | # 049111697

BRIAN J BAUTISTA

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049111697

License Status

NOT RENEWED

Business

N

First Name

BRIAN

Middle

J

Last Name

BAUTISTA

Business Name

BRIAN J BAUTISTA

Original Issue Date

09/12/1995

Effective Date

09/12/1995

Expiration Date

03/31/2000

State

IL

Ever Disciplined

N

LastModifiedDate

10/21/2005