CINDERELLA DERMAWAN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049131663

License Status

NOT RENEWED

Business

First Name

CINDERELLA

Last Name

DERMAWAN

Business Name

CINDERELLA DERMAWAN

Original Issue Date

07/18/2000

Effective Date

07/18/2000

Expiration Date

03/31/2002

City

CHICAGO

State

Zip

60661

County

COOK

Ever Disciplined

LastModifiedDate

12/06/2005