DAVID DISSEN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049148943

License Status

NOT RENEWED

Business

First Name

DAVID

Last Name

DISSEN

Business Name

DAVID DISSEN

Original Issue Date

06/16/2003

Effective Date

06/16/2003

Expiration Date

03/31/2004

City

CHICAGO

State

Zip

60659

County

COOK

Ever Disciplined

LastModifiedDate

10/20/2005