SHANE R COSTELLO - Pharmacist License in Illinois | # 049163362

SHANE R COSTELLO

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049163362

License Status

NOT RENEWED

Business

N

First Name

SHANE

Middle

R

Last Name

COSTELLO

Business Name

SHANE R COSTELLO

Original Issue Date

08/30/2005

Effective Date

08/30/2005

Expiration Date

03/31/2006

State

IL

Ever Disciplined

N

LastModifiedDate

05/11/2006