GERVASIS MANUEL - Pharmacist License in Illinois | # 049153025

GERVASIS MANUEL

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049153025

License Status

NOT RENEWED

Business

N

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

State

IL

Ever Disciplined

N

LastModifiedDate

10/20/2005