FANTA ELISE LIDDELL Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049150684

License Status

NOT RENEWED

Business

First Name

FANTA

Middle

ELISE

Last Name

LIDDELL

Business Name

FANTA ELISE LIDDELL

Original Issue Date

09/19/2003

Effective Date

09/19/2003

Expiration Date

03/31/2006

City

CHICAGO

State

Zip

60628

Ever Disciplined

LastModifiedDate

05/11/2006