BARBARA J FORMAN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049114204

License Status

NOT RENEWED

Business

First Name

BARBARA J

Last Name

FORMAN

Business Name

BARBARA J FORMAN

Original Issue Date

05/08/1996

Effective Date

05/08/1996

Expiration Date

03/31/1998

City

DEERFIELD

State

Zip

60015

County

COOK

Ever Disciplined

LastModifiedDate

10/17/2005