PORTIA M SULLIVAN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049149402

License Status

NOT RENEWED

Business

First Name

PORTIA

Middle

Last Name

SULLIVAN

Business Name

PORTIA M SULLIVAN

Original Issue Date

07/01/2003

Effective Date

07/01/2003

Expiration Date

03/31/2004

City

MATTESON

State

Zip

60443

County

COOK

Ever Disciplined

LastModifiedDate

10/20/2005