GEORGE OTAR BURJANADZE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049140937

License Status

NOT RENEWED

Business

First Name

GEORGE

Middle

OTAR

Last Name

BURJANADZE

Business Name

GEORGE OTAR BURJANADZE

Original Issue Date

02/21/2002

Effective Date

02/21/2002

Expiration Date

03/31/2003

City

PARK RIDGE

State

Zip

60068

County

COOK

Ever Disciplined

LastModifiedDate

10/20/2005