NISA MARIE FORTINEAUX Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049208647

License Status

NOT RENEWED

Business

First Name

NISA

Middle

MARIE

Last Name

FORTINEAUX

Business Name

NISA MARIE FORTINEAUX

Original Issue Date

01/10/2012

Effective Date

03/20/2014

Expiration Date

03/31/2015

City

FRANKFORT

State

Zip

60423

Ever Disciplined

LastModifiedDate

05/11/2015