DAVID DANIEL GUSTAVSON Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049152415

License Status

NOT RENEWED

Business

First Name

DAVID DANIEL

Last Name

GUSTAVSON

Business Name

DAVID DANIEL GUSTAVSON

Original Issue Date

12/10/2003

Effective Date

12/10/2003

Expiration Date

03/31/2005

City

ARLINGTON HEIGHTS

State

Zip

60005

County

COOK

Ever Disciplined

LastModifiedDate

10/20/2005