MICHAEL R SPIVAKOV Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049201550

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

Last Name

SPIVAKOV

Business Name

MICHAEL R SPIVAKOV

Original Issue Date

11/15/2010

Effective Date

11/15/2010

Expiration Date

03/31/2011

City

ROUND LAKE

State

Zip

60073

County

LAKE

Ever Disciplined

LastModifiedDate

12/08/2012