BENJAMIN COLLIN PTAK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049143211

License Status

NOT RENEWED

Business

First Name

BENJAMIN

Middle

COLLIN

Last Name

PTAK

Business Name

BENJAMIN COLLIN PTAK

Original Issue Date

06/14/2002

Effective Date

06/14/2002

Expiration Date

03/31/2003

City

BOLINGBROOK

State

Zip

60440

County

WILL

Ever Disciplined

LastModifiedDate

10/20/2005