FEDAA M BALLOUTA - Pharmacist License in Illinois | # 049159511

FEDAA M BALLOUTA

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049159511

License Status

NOT RENEWED

Business

N

First Name

FEDAA

Middle

M

Last Name

BALLOUTA

Business Name

FEDAA M BALLOUTA

Original Issue Date

03/09/2005

Effective Date

02/05/2019

Expiration Date

09/30/2020

State

IL

Ever Disciplined

N

LastModifiedDate

01/08/2021