DANIEL WILLIAM SUPITILOV Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049116710

License Status

NOT RENEWED

Business

First Name

DANIEL

Middle

WILLIAM

Last Name

SUPITILOV

Business Name

DANIEL WILLIAM SUPITILOV

Original Issue Date

03/06/1997

Effective Date

03/19/2007

Expiration Date

03/31/2008

City

MELROSE PARK

State

Zip

60160

County

COOK

Ever Disciplined

LastModifiedDate

05/02/2008