MARK JOSEPH BOUSSELOT - Pharmacist License in Illinois | # 049137519

MARK JOSEPH BOUSSELOT

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049137519

License Status

NOT RENEWED

Business

N

First Name

MARK

Middle

JOSEPH

Last Name

BOUSSELOT

Business Name

MARK JOSEPH BOUSSELOT

Original Issue Date

08/07/2001

Effective Date

08/07/2001

Expiration Date

03/31/2006

State

IL

Ever Disciplined

N

LastModifiedDate

05/11/2006