SHANTIVIA P RELIFORD Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049158542

License Status

NOT RENEWED

Business

First Name

SHANTIVIA

Middle

Last Name

RELIFORD

Business Name

SHANTIVIA P RELIFORD

Original Issue Date

12/22/2004

Effective Date

12/22/2004

Expiration Date

03/31/2006

City

CHICAGO

State

Zip

60636

County

COOK

Ever Disciplined

LastModifiedDate

05/11/2006