ANNIE JULIA SUPPLE - Pharmacist License in Illinois | # 049154534

ANNIE JULIA SUPPLE

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049154534

License Status

NOT RENEWED

Business

N

First Name

ANNIE

Middle

JULIA

Last Name

SUPPLE

Business Name

ANNIE JULIA SUPPLE

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