ADAM N SIETSEMA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049145648

License Status

NOT RENEWED

Business

First Name

ADAM

Middle

Last Name

SIETSEMA

Business Name

ADAM N SIETSEMA

Original Issue Date

11/04/2002

Effective Date

11/04/2002

Expiration Date

03/31/2003

City

RIVER GROVE

State

Zip

60171

County

COOK

Ever Disciplined

LastModifiedDate

10/20/2005