RANDOLPH R MIRANDA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049154225

License Status

NOT RENEWED

Business

First Name

RANDOLPH

Middle

Last Name

MIRANDA

Business Name

RANDOLPH R MIRANDA

Original Issue Date

04/29/2004

Effective Date

04/29/2004

Expiration Date

03/31/2005

City

CHICAGO

State

Zip

60646

County

COOK

Ever Disciplined

LastModifiedDate

10/20/2005