HEATHER E TIEBOUT Pharmacist License verification

Business Entity

INACTIVE

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049179687

License Status

INACTIVE

Business

First Name

HEATHER

Middle

Last Name

TIEBOUT

Business Name

HEATHER E TIEBOUT

BusinessDBA

LOGAN

Original Issue Date

10/02/2007

Effective Date

10/02/2007

Expiration Date

03/31/2008

City

CHICAGO

State

Zip

60644

County

COOK

Ever Disciplined

LastModifiedDate

01/10/2008