ELLIOT GRANT BRTVA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049128715

License Status

NOT RENEWED

Business

First Name

ELLIOT

Middle

GRANT

Last Name

BRTVA

Business Name

ELLIOT GRANT BRTVA

Original Issue Date

12/23/1999

Effective Date

12/23/1999

Expiration Date

03/31/2006

City

LOCKPORT

State

Zip

60441

County

WILL

Ever Disciplined

LastModifiedDate

05/11/2006