DOUGLAS O SLACK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049130656

License Status

NOT RENEWED

Business

First Name

DOUGLAS

Middle

Last Name

SLACK

Business Name

DOUGLAS O SLACK

Original Issue Date

04/24/2000

Effective Date

04/24/2000

Expiration Date

03/31/2005

City

GILMAN

State

Zip

60938

County

IROQUOIS

Ever Disciplined

LastModifiedDate

10/20/2005