TAVIS ROMAN KACZANOWSKI Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049139160

License Status

NOT RENEWED

Business

First Name

TAVIS

Middle

ROMAN

Last Name

KACZANOWSKI

Business Name

TAVIS ROMAN KACZANOWSKI

Original Issue Date

11/09/2001

Effective Date

11/09/2001

Expiration Date

03/31/2002

City

NEW LENOX

State

Zip

60451

County

WILL

Ever Disciplined

LastModifiedDate

12/06/2005