TRISTA L BLACK - Pharmacist License in Illinois | # 049114766

TRISTA L BLACK

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049114766

License Status

NOT RENEWED

Business

N

First Name

TRISTA L

Last Name

BLACK

Business Name

TRISTA L BLACK

Original Issue Date

08/01/1996

Effective Date

08/01/1996

Expiration Date

03/31/2000

State

IL

Ever Disciplined

N

LastModifiedDate

10/21/2005