PAYAL D MODI Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049154311

License Status

NOT RENEWED

Business

First Name

PAYAL

Middle

Last Name

MODI

Business Name

PAYAL D MODI

Original Issue Date

05/19/2004

Effective Date

02/06/2012

Expiration Date

03/31/2013

City

HANOVER PARK

State

Zip

60133

County

COOK

Ever Disciplined

LastModifiedDate

05/06/2013