DANIEL WILLIAM SUPITILOV - Pharmacist License in Illinois | # 049116710

DANIEL WILLIAM SUPITILOV

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049116710

License Status

NOT RENEWED

Business

N

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

State

IL

Ever Disciplined

N

LastModifiedDate

05/02/2008