LOGAN L BONGLORSI Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049159237

License Status

NOT RENEWED

Business

First Name

LOGAN

Middle

Last Name

BONGLORSI

Business Name

LOGAN L BONGLORSI

Original Issue Date

02/14/2005

Effective Date

02/14/2005

Expiration Date

03/31/2006

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Ever Disciplined

LastModifiedDate

05/11/2006