SISA D TAN - Pharmacist License in Illinois | # 049164299

SISA D TAN

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049164299

License Status

NOT RENEWED

Business

N

First Name

SISA

Middle

D

Last Name

TAN

Business Name

SISA D TAN

Original Issue Date

09/30/2005

Effective Date

01/09/2007

Expiration Date

03/31/2008

State

IL

Ever Disciplined

N

LastModifiedDate

05/02/2008