BENNY M MATHEW Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049157617

License Status

NOT RENEWED

Business

First Name

BENNY

Middle

Last Name

MATHEW

Business Name

BENNY M MATHEW

Original Issue Date

10/27/2004

Effective Date

10/27/2004

Expiration Date

03/31/2005

City

ROUND LAKE BEACH

State

Zip

60073

County

LAKE

Ever Disciplined

LastModifiedDate

10/20/2005