PAM TIFFANY PUA CAPULONG Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049208525

License Status

NOT RENEWED

Business

First Name

PAM TIFFANY

Middle

PUA

Last Name

CAPULONG

Business Name

PAM TIFFANY PUA CAPULONG

Original Issue Date

01/03/2012

Effective Date

03/04/2013

Expiration Date

03/31/2014

City

LOMBARD

State

Zip

60148

Ever Disciplined

LastModifiedDate

05/06/2014