AUTUMN Y SUSBERRY Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049176367

License Status

NOT RENEWED

Business

First Name

AUTUMN

Middle

Last Name

SUSBERRY

Business Name

AUTUMN Y SUSBERRY

Original Issue Date

05/16/2007

Effective Date

02/25/2009

Expiration Date

03/31/2010

City

CHICAGO

State

Zip

60637

County

COOK

Ever Disciplined

LastModifiedDate

05/04/2010