SCOTT W BLACK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049126690

License Status

NOT RENEWED

Business

First Name

SCOTT

Middle

Last Name

BLACK

Business Name

SCOTT W BLACK

Original Issue Date

07/13/1999

Effective Date

07/13/1999

Expiration Date

03/31/2004

City

CHICAGO

State

Zip

60632

County

COOK

Ever Disciplined

LastModifiedDate

10/20/2005