LESLIE TAN JUAN - Pharmacist License in Illinois | # 049153804

LESLIE TAN JUAN

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049153804

License Status

NOT RENEWED

Business

N

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

State

IL

Ever Disciplined

N

LastModifiedDate

10/20/2005