KATHLEEN MARGARET FORTMANN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049157937

License Status

NOT RENEWED

Business

First Name

KATHLEEN

Middle

MARGARET

Last Name

FORTMANN

Business Name

KATHLEEN MARGARET FORTMANN

Original Issue Date

11/18/2004

Effective Date

03/11/2009

Expiration Date

03/31/2010

City

ELK GROVE VILLAGE

State

Zip

60007

County

COOK

Ever Disciplined

LastModifiedDate

05/04/2010