JEAN ELLEN VITALE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049207126

License Status

NOT RENEWED

Business

First Name

JEAN

Middle

ELLEN

Last Name

VITALE

Business Name

JEAN ELLEN VITALE

Original Issue Date

10/05/2011

Effective Date

02/09/2012

Expiration Date

03/31/2013

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/06/2013