MARILOU V DAZA - Pharmacist License in Illinois | # 049115650

MARILOU V DAZA

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049115650

License Status

NOT RENEWED

Business

N

First Name

MARILOU

Middle

V

Last Name

DAZA

Business Name

MARILOU V DAZA

Original Issue Date

10/23/1996

Effective Date

10/23/1996

Expiration Date

03/31/2002

State

IL

Ever Disciplined

N

LastModifiedDate

12/06/2005