D ALEX PROVIDO Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049201638

License Status

NOT RENEWED

Business

First Name

D ALEX

Last Name

PROVIDO

Business Name

D ALEX PROVIDO

Original Issue Date

11/22/2010

Effective Date

11/22/2010

Expiration Date

03/31/2011

City

FRANKLIN PARK

State

Zip

60131

County

COOK

Ever Disciplined

LastModifiedDate

05/12/2011