DYLAN RAEL FORSTON Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049143534

License Status

NOT RENEWED

Business

First Name

DYLAN

Middle

RAEL

Last Name

FORSTON

Business Name

DYLAN RAEL FORSTON

Original Issue Date

07/03/2002

Effective Date

07/03/2002

Expiration Date

03/31/2003

City

SYCAMORE

State

Zip

60178

County

DEKALB

Ever Disciplined

LastModifiedDate

10/20/2005