TATIERRA S BIVENS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049207068

License Status

NOT RENEWED

Business

First Name

TATIERRA

Middle

Last Name

BIVENS

Business Name

TATIERRA S BIVENS

Original Issue Date

10/03/2011

Effective Date

03/08/2012

Expiration Date

03/31/2013

City

CHICAGO

State

Zip

60636

County

COOK

Ever Disciplined

LastModifiedDate

05/06/2013