MARIE T RUSSOM Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049162021

License Status

NOT RENEWED

Business

First Name

MARIE

Middle

Last Name

RUSSOM

Business Name

MARIE T RUSSOM

Original Issue Date

06/30/2005

Effective Date

02/11/2009

Expiration Date

03/31/2010

City

CARPENTERSVILLE

State

Zip

60110

County

KANE

Ever Disciplined

LastModifiedDate

05/04/2010