FONTELLA D BROCK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049182066

License Status

NOT RENEWED

Business

First Name

FONTELLA

Middle

Last Name

BROCK

Business Name

FONTELLA D BROCK

Original Issue Date

02/07/2008

Effective Date

04/01/2009

Expiration Date

03/31/2010

City

CHICAGO

State

Zip

60620

County

COOK

Ever Disciplined

LastModifiedDate

05/04/2010