LESLIE TAN JUAN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049153804

License Status

NOT RENEWED

Business

First Name

LESLIE

Middle

TAN

Last Name

JUAN

Business Name

LESLIE TAN JUAN

Original Issue Date

03/19/2004

Effective Date

03/19/2004

Expiration Date

03/31/2005

City

CHICAGO

State

Zip

60638

County

COOK

Ever Disciplined

LastModifiedDate

10/20/2005