MIACERRA ADRIANNA LAKE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049177059

License Status

NOT RENEWED

Business

First Name

MIACERRA

Middle

ADRIANNA

Last Name

LAKE

Business Name

MIACERRA ADRIANNA LAKE

Original Issue Date

06/15/2007

Effective Date

08/31/2011

Expiration Date

03/31/2012

City

CHICAGO

State

Zip

60617

County

COOK

Ever Disciplined

LastModifiedDate

05/07/2012