KRYSTAL DESIREE OSTALAZA DIAZ Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049174165

License Status

NOT RENEWED

Business

First Name

KRYSTAL

Middle

DESIREE

Last Name

OSTALAZA DIAZ

Business Name

KRYSTAL DESIREE OSTALAZA DIAZ

Original Issue Date

02/06/2007

Effective Date

09/19/2012

Expiration Date

03/31/2013

City

CRYSTAL LAKE

State

Zip

60014

County

MCHENRY

Ever Disciplined

LastModifiedDate

05/06/2013