ADAM CHARLES BLACK OD Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049124980

License Status

NOT RENEWED

Business

Title

First Name

ADAM

Middle

CHARLES

Last Name

BLACK

Business Name

ADAM CHARLES BLACK OD

Original Issue Date

03/10/1999

Effective Date

03/10/1999

Expiration Date

03/31/2003

City

NAPERVILLE

State

Zip

60540

County

DUPAGE

Ever Disciplined

LastModifiedDate

10/20/2005