SHANE R COSTELLO Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049163362

License Status

NOT RENEWED

Business

First Name

SHANE

Middle

Last Name

COSTELLO

Business Name

SHANE R COSTELLO

Original Issue Date

08/30/2005

Effective Date

08/30/2005

Expiration Date

03/31/2006

City

DES PLAINES

State

Zip

60016

County

COOK

Ever Disciplined

LastModifiedDate

05/11/2006