NICOLE A FORNELL Pharmacist License verification

Business Entity

INACTIVE

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049155310

License Status

INACTIVE

Business

First Name

NICOLE

Middle

Last Name

FORNELL

Business Name

NICOLE A FORNELL

Original Issue Date

06/17/2004

Effective Date

01/10/2013

Expiration Date

03/31/2014

City

SYCAMORE

State

Zip

60178

County

DEKALB

Ever Disciplined

LastModifiedDate

01/09/2014