MALLORY ANNE KRUCKMAN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049162295

License Status

NOT RENEWED

Business

First Name

MALLORY

Middle

ANNE

Last Name

KRUCKMAN

Business Name

MALLORY ANNE KRUCKMAN

Original Issue Date

07/15/2005

Effective Date

01/25/2010

Expiration Date

03/31/2011

City

LIBERTYVILLE

State

Zip

60048

County

LAKE

Ever Disciplined

LastModifiedDate

05/12/2011