SACHI NICOL FORMAN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049130547

License Status

NOT RENEWED

Business

First Name

SACHI

Middle

NICOL

Last Name

FORMAN

Business Name

SACHI NICOL FORMAN

Original Issue Date

04/14/2000

Effective Date

03/08/2010

Expiration Date

03/31/2011

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Ever Disciplined

LastModifiedDate

05/12/2011