RACHEL B FORMAN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049200643

License Status

NOT RENEWED

Business

First Name

RACHEL

Middle

Last Name

FORMAN

Prefix

Business Name

RACHEL B FORMAN

Original Issue Date

09/20/2010

Effective Date

09/20/2010

Expiration Date

03/31/2011

City

DEERFIELD

State

Zip

60015

County

LAKE

Ever Disciplined

LastModifiedDate

05/12/2011