GERVASIS MANUEL Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049153025

License Status

NOT RENEWED

Business

First Name

GERVASIS

Last Name

MANUEL

Business Name

GERVASIS MANUEL

Original Issue Date

01/27/2004

Effective Date

01/27/2004

Expiration Date

03/31/2005

City

ELMHURST

State

Zip

60126

County

DUPAGE

Ever Disciplined

LastModifiedDate

10/20/2005