LESLIE L BALSAMELLO Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049148524

License Status

NOT RENEWED

Business

First Name

LESLIE

Middle

Last Name

BALSAMELLO

Business Name

LESLIE L BALSAMELLO

Original Issue Date

05/13/2003

Effective Date

02/22/2012

Expiration Date

03/31/2013

City

WESTVILLE

State

Zip

61883

County

VERMILION

Ever Disciplined

LastModifiedDate

05/06/2013