EDMUNDO G DELA PROVIDENCIA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049161801

License Status

NOT RENEWED

Business

First Name

EDMUNDO

Middle

Last Name

DELA PROVIDENCIA

Business Name

EDMUNDO G DELA PROVIDENCIA

Original Issue Date

06/21/2005

Effective Date

04/15/2015

Expiration Date

03/31/2016

City

CHICAGO

State

Zip

60625

County

COOK

Ever Disciplined

LastModifiedDate

05/20/2016