DINA ROSA BAZAN - Pharmacist License in Illinois | # 049124237

DINA ROSA BAZAN

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049124237

License Status

NOT RENEWED

Business

N

First Name

DINA

Middle

ROSA

Last Name

BAZAN

Business Name

DINA ROSA BAZAN

Original Issue Date

12/21/1998

Effective Date

12/21/1998

Expiration Date

03/31/2001

State

IL

Ever Disciplined

N

LastModifiedDate

10/21/2005