BRENT HERBERT BROKHOF Pharmacist License verification

Business Entity

INACTIVE

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049155857

License Status

INACTIVE

Business

First Name

BRENT

Middle

HERBERT

Last Name

BROKHOF

Business Name

BRENT HERBERT BROKHOF

Original Issue Date

06/29/2004

Effective Date

03/29/2010

Expiration Date

03/31/2011

City

ELMHURST

State

Zip

60126

County

DUPAGE

Ever Disciplined

LastModifiedDate

01/05/2011