EDNA NONATO FORMAN - Pharmacist License in Illinois | # 049158411

EDNA NONATO FORMAN

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049158411

License Status

NOT RENEWED

Business

N

First Name

EDNA

Middle

NONATO

Last Name

FORMAN

Business Name

EDNA NONATO FORMAN

Original Issue Date

12/16/2004

Effective Date

01/09/2007

Expiration Date

03/31/2008

State

IL

Ever Disciplined

N

LastModifiedDate

05/02/2008