DIANE J PEVONKA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049112000

License Status

NOT RENEWED

Business

First Name

DIANE J

Last Name

PEVONKA

Business Name

DIANE J PEVONKA

Original Issue Date

10/04/1995

Effective Date

10/04/1995

Expiration Date

03/31/1998

City

DEKALB

State

Zip

60115

County

DEKALB

Ever Disciplined

LastModifiedDate

10/17/2005