SHANE MICHAEL GOSSELINK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049118123

License Status

NOT RENEWED

Business

First Name

SHANE

Middle

MICHAEL

Last Name

GOSSELINK

Business Name

SHANE MICHAEL GOSSELINK

Original Issue Date

07/15/1997

Effective Date

07/15/1997

Expiration Date

03/31/2003

City

CHICAGO

State

Zip

60659

County

COOK

Ever Disciplined

LastModifiedDate

10/20/2005