DIANE BAUTISTA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049206842

License Status

NOT RENEWED

Business

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

City

ROMEOVILLE

State

Zip

60446

County

WILL

Ever Disciplined

LastModifiedDate

05/07/2012