MARK ALLEN MODER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049124169

License Status

NOT RENEWED

Business

First Name

MARK

Middle

ALLEN

Last Name

MODER

Business Name

MARK ALLEN MODER

Original Issue Date

12/16/1998

Effective Date

12/16/1998

Expiration Date

03/31/2003

City

MOUNT PROSPECT

State

Zip

60056

County

COOK

Ever Disciplined

LastModifiedDate

10/20/2005