AMANDA M SELF Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049148784

License Status

NOT RENEWED

Business

First Name

AMANDA

Middle

Last Name

SELF

Business Name

AMANDA M SELF

Original Issue Date

06/09/2003

Effective Date

06/09/2003

Expiration Date

03/31/2004

City

ROUND LAKE BEACH

State

Zip

60073

County

LAKE

Ever Disciplined

LastModifiedDate

10/20/2005