DONNA R TIETEMA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049181437

License Status

NOT RENEWED

Business

First Name

DONNA

Middle

Last Name

TIETEMA

Business Name

DONNA R TIETEMA

Original Issue Date

01/08/2008

Effective Date

01/08/2008

Expiration Date

03/31/2009

City

GRAYSLAKE

State

Zip

60030

County

LAKE

Ever Disciplined

LastModifiedDate

05/06/2009