MISTY D STALLWORTH Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049160659

License Status

NOT RENEWED

Business

First Name

MISTY

Middle

Last Name

STALLWORTH

Business Name

MISTY D STALLWORTH

Original Issue Date

04/28/2005

Effective Date

09/28/2010

Expiration Date

03/31/2011

City

CHICAGO

State

Zip

60644

County

COOK

Ever Disciplined

LastModifiedDate

05/12/2011