CAGNEY C FULLENWILDER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049147778

License Status

NOT RENEWED

Business

First Name

CAGNEY

Middle

Last Name

FULLENWILDER

Business Name

CAGNEY C FULLENWILDER

Original Issue Date

04/02/2003

Effective Date

04/02/2003

Expiration Date

03/31/2004

City

CHICAGO

State

Zip

60617

County

COOK

Ever Disciplined

LastModifiedDate

10/20/2005