RUSSATTA I ISOM Pharmacist License verification

Business Entity

INACTIVE

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049127650

License Status

INACTIVE

Business

First Name

RUSSATTA

Middle

Last Name

ISOM

Business Name

RUSSATTA I ISOM

Original Issue Date

09/24/1999

Effective Date

01/09/2007

Expiration Date

03/31/2008

City

CHICAGO

State

Zip

60619

County

COOK

Ever Disciplined

LastModifiedDate

01/10/2008