DIWANTE JAMAL SHUFORD MD Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049185703

License Status

NOT RENEWED

Business

Title

First Name

DIWANTE

Middle

JAMAL

Last Name

SHUFORD

Business Name

DIWANTE JAMAL SHUFORD MD

Original Issue Date

07/23/2008

Effective Date

03/27/2009

Expiration Date

03/31/2010

City

DOLTON

State

Zip

60419

County

COOK

Ever Disciplined

LastModifiedDate

05/04/2010