BRIAN STEPHEN FULKA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049137756

License Status

NOT RENEWED

Business

First Name

BRIAN

Middle

STEPHEN

Last Name

FULKA

Business Name

BRIAN STEPHEN FULKA

Original Issue Date

08/15/2001

Effective Date

08/15/2001

Expiration Date

03/31/2004

City

NEW LENOX

State

Zip

60451

County

WILL

Ever Disciplined

LastModifiedDate

10/20/2005