ANTHONY M DIETZ Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049157618

License Status

NOT RENEWED

Business

First Name

ANTHONY

Middle

Last Name

DIETZ

Business Name

ANTHONY M DIETZ

Original Issue Date

10/27/2004

Effective Date

01/18/2011

Expiration Date

03/31/2012

City

HOMETOWN

State

Zip

60456

County

COOK

Ever Disciplined

LastModifiedDate

05/07/2012