CRYSTAL A DIEPEVEEN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049194113

License Status

NOT RENEWED

Business

First Name

CRYSTAL

Middle

Last Name

DIEPEVEEN

Prefix

Business Name

CRYSTAL A DIEPEVEEN

Original Issue Date

09/08/2009

Effective Date

02/25/2021

Expiration Date

05/31/2022

City

BOURBONNAIS

State

Zip

60914

County

KANKAKEE

Ever Disciplined

LastModifiedDate

07/27/2022