RICHARD RUSSEL SAMPLE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049178737

License Status

NOT RENEWED

Business

First Name

RICHARD

Middle

RUSSEL

Last Name

SAMPLE

Business Name

RICHARD RUSSEL SAMPLE

Original Issue Date

08/27/2007

Effective Date

03/20/2013

Expiration Date

03/31/2014

City

MOUNT PROSPECT

State

Zip

60056

County

COOK

Ever Disciplined

LastModifiedDate

05/06/2014