CHARLES A FOUNTAIN III Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049166707

License Status

NOT RENEWED

Business

First Name

CHARLES

Middle

Last Name

FOUNTAIN

Suffix

III

Business Name

CHARLES A FOUNTAIN III

Original Issue Date

03/08/2006

Effective Date

02/03/2012

Expiration Date

03/31/2013

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Ever Disciplined

LastModifiedDate

05/06/2013