ELIZABETH ANN PROVANCE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049137618

License Status

NOT RENEWED

Business

First Name

ELIZABETH

Middle

ANN

Last Name

PROVANCE

Business Name

ELIZABETH ANN PROVANCE

Original Issue Date

08/08/2001

Effective Date

08/08/2001

Expiration Date

03/31/2006

City

BOURBONNAIS

State

Zip

60914

County

KANKAKEE

Ever Disciplined

LastModifiedDate

05/14/2007