DIANE L VANGOETHEM Pharmacist License verification

Business Entity

INACTIVE

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049208046

License Status

INACTIVE

Business

First Name

DIANE

Middle

Last Name

VANGOETHEM

Business Name

DIANE L VANGOETHEM

Original Issue Date

11/29/2011

Effective Date

02/21/2012

Expiration Date

03/31/2013

City

CRYSTAL LAKE

State

Zip

60012

County

MCHENRY

Ever Disciplined

LastModifiedDate

01/03/2013