DAIQUIRI HAZEL HARLAN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049193028

License Status

NOT RENEWED

Business

First Name

DAIQUIRI

Middle

HAZEL

Last Name

HARLAN

Business Name

DAIQUIRI HAZEL HARLAN

Original Issue Date

07/16/2009

Effective Date

08/16/2011

Expiration Date

03/31/2012

City

MAYWOOD

State

Zip

60153

County

COOK

Ever Disciplined

LastModifiedDate

05/07/2012