MARK C BASHAM Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049119982

License Status

NOT RENEWED

Business

First Name

MARK

Middle

Last Name

BASHAM

Business Name

MARK C BASHAM

Original Issue Date

02/03/1998

Effective Date

01/19/2006

Expiration Date

03/31/2007

City

GLENDALE HEIGHTS

State

Zip

60139

County

DUPAGE

Ever Disciplined

LastModifiedDate

05/14/2007