PATERY A LAKE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049153696

License Status

NOT RENEWED

Business

First Name

PATERY

Middle

Last Name

LAKE

Business Name

PATERY A LAKE

Original Issue Date

03/16/2004

Effective Date

03/16/2004

Expiration Date

03/31/2005

City

CHICAGO

State

Zip

60628

County

COOK

Ever Disciplined

LastModifiedDate

10/20/2005