JONATHAN FREDERIC FORNEK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049142776

License Status

NOT RENEWED

Business

First Name

JONATHAN

Middle

FREDERIC

Last Name

FORNEK

Business Name

JONATHAN FREDERIC FORNEK

Original Issue Date

05/30/2002

Effective Date

05/30/2002

Expiration Date

03/31/2005

City

BARTLETT

State

Zip

60103

County

COOK

Ever Disciplined

LastModifiedDate

10/20/2005