MIA R MACK - Pharmacist License in Illinois | # 049154494

MIA R MACK

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049154494

License Status

NOT RENEWED

Business

N

First Name

MIA

Middle

R

Last Name

MACK

Business Name

MIA R MACK

Original Issue Date

05/21/2004

Effective Date

05/21/2004

Expiration Date

03/31/2005

State

IL

Ever Disciplined

N

LastModifiedDate

10/20/2005