MARY RUBY ISA MATEN BUSTAMANTE - Pharmacist License in Illinois | # 049148681

MARY RUBY ISA MATEN BUSTAMANTE

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049148681

License Status

NOT RENEWED

Business

N

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

State

IL

Ever Disciplined

N

LastModifiedDate

10/20/2005