TERRI L KSIAZEK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049124196

License Status

NOT RENEWED

Business

First Name

TERRI

Middle

Last Name

KSIAZEK

Business Name

TERRI L KSIAZEK

Original Issue Date

12/17/1998

Effective Date

12/17/1998

Expiration Date

03/31/2003

City

OAK LAWN

State

Zip

60453

County

COOK

Ever Disciplined

LastModifiedDate

10/20/2005