DINA ROSA BAZAN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049124237

License Status

NOT RENEWED

Business

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

City

BOLINGBROOK

State

Zip

60440

County

WILL

Ever Disciplined

LastModifiedDate

10/21/2005