MARY RUBY ISA MATEN BUSTAMANTE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049148681

License Status

NOT RENEWED

Business

First Name

MARY RUBY ISA

Middle

MATEN

Last Name

BUSTAMANTE

Business Name

MARY RUBY ISA MATEN BUSTAMANTE

Original Issue Date

06/03/2003

Effective Date

06/03/2003

Expiration Date

03/31/2004

City

CHICAGO

State

Zip

60625

County

COOK

Ever Disciplined

LastModifiedDate

10/20/2005