BRANDON LAMAR CORRELL-MOSS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049164234

License Status

NOT RENEWED

Business

First Name

BRANDON

Middle

LAMAR

Last Name

CORRELL-MOSS

Business Name

BRANDON LAMAR CORRELL-MOSS

Original Issue Date

09/28/2005

Effective Date

09/28/2005

Expiration Date

03/31/2006

City

CHICAGO

State

Zip

60615

County

COOK

Ever Disciplined

LastModifiedDate

05/11/2006