MARIE ANTOINETTE FAIRFAX Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049164314

License Status

NOT RENEWED

Business

First Name

MARIE

Middle

ANTOINETTE

Last Name

FAIRFAX

Business Name

MARIE ANTOINETTE FAIRFAX

Original Issue Date

10/03/2005

Effective Date

03/16/2007

Expiration Date

03/31/2008

City

CHICAGO

State

Zip

60617

County

COOK

Ever Disciplined

LastModifiedDate

05/02/2008