MARIAM ETHEZAZ OD Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049199168

License Status

NOT RENEWED

Business

Title

First Name

MARIAM

Last Name

ETHEZAZ

Business Name

MARIAM ETHEZAZ OD

Original Issue Date

07/01/2010

Effective Date

07/01/2010

Expiration Date

03/31/2011

City

CHICAGO

State

Zip

60625

County

COOK

Ever Disciplined

LastModifiedDate

05/12/2011