FAZAL M PUTHAWALA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049115129

License Status

NOT RENEWED

Business

First Name

FAZAL

Middle

Last Name

PUTHAWALA

Business Name

FAZAL M PUTHAWALA

Original Issue Date

08/29/1996

Effective Date

08/29/1996

Expiration Date

03/31/2003

City

CHICAGO

State

Zip

60625

County

COOK

Ever Disciplined

LastModifiedDate

10/20/2005