STEPHANIE J FORKENBOCK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049131010

License Status

NOT RENEWED

Business

First Name

STEPHANIE

Middle

Last Name

FORKENBOCK

Business Name

STEPHANIE J FORKENBOCK

Original Issue Date

06/01/2000

Effective Date

03/29/2011

Expiration Date

03/31/2012

City

BOURBONNAIS

State

Zip

60914

County

KANKAKEE

Ever Disciplined

LastModifiedDate

05/07/2012