DIANE BAUTISTA - Pharmacist License in Illinois | # 049206842

DIANE BAUTISTA

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049206842

License Status

NOT RENEWED

Business

N

First Name

DIANE

Last Name

BAUTISTA

Business Name

DIANE BAUTISTA

Original Issue Date

09/21/2011

Effective Date

09/21/2011

Expiration Date

03/31/2012

State

IL

Ever Disciplined

N

LastModifiedDate

05/07/2012