MARILOU V DAZA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049115650

License Status

NOT RENEWED

Business

First Name

MARILOU

Middle

Last Name

DAZA

Business Name

MARILOU V DAZA

Original Issue Date

10/23/1996

Effective Date

10/23/1996

Expiration Date

03/31/2002

City

RIVER FOREST

State

Zip

60305

County

COOK

Ever Disciplined

LastModifiedDate

12/06/2005