DIANE M VERVACK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049160724

License Status

NOT RENEWED

Business

First Name

DIANE

Middle

Last Name

VERVACK

Business Name

DIANE M VERVACK

Original Issue Date

05/03/2005

Effective Date

05/03/2005

Expiration Date

03/31/2006

City

WESTMONT

State

Zip

60559

County

DUPAGE

Ever Disciplined

LastModifiedDate

05/11/2006