ADAM C TIAGONCE MD Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049192277

License Status

NOT RENEWED

Business

Title

First Name

ADAM

Middle

Last Name

TIAGONCE

Business Name

ADAM C TIAGONCE MD

Original Issue Date

06/11/2009

Effective Date

03/15/2011

Expiration Date

03/31/2012

City

BUFFALO GROVE

State

Zip

60089

County

LAKE

Ever Disciplined

LastModifiedDate

05/07/2012