MICHAEL P PENA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049151853

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

Last Name

PENA

Business Name

MICHAEL P PENA

Original Issue Date

10/24/2003

Effective Date

10/24/2003

Expiration Date

03/31/2006

City

LA SALLE

State

Zip

61301

County

LA SALLE

Ever Disciplined

LastModifiedDate

05/11/2006