SIMON M THEODULE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049140553

License Status

NOT RENEWED

Business

First Name

SIMON

Middle

Last Name

THEODULE

Business Name

SIMON M THEODULE

Original Issue Date

02/06/2002

Effective Date

02/06/2002

Expiration Date

03/31/2003

City

CHICAGO

State

Zip

60643

County

COOK

Ever Disciplined

LastModifiedDate

10/20/2005