PAULETTE LAVENIUS LONG Pharmacist License verification

Business Entity

INACTIVE

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049195375

License Status

INACTIVE

Business

First Name

PAULETTE

Middle

LAVENIUS

Last Name

LONG

Business Name

PAULETTE LAVENIUS LONG

Original Issue Date

11/17/2009

Effective Date

01/09/2014

Expiration Date

03/31/2015

City

SOUTH HOLLAND

State

Zip

60473

County

COOK

Ever Disciplined

LastModifiedDate

01/06/2015