WILLARD B FOUNTAIN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049210049

License Status

NOT RENEWED

Business

First Name

WILLARD

Middle

Last Name

FOUNTAIN

Prefix

Business Name

WILLARD B FOUNTAIN

Original Issue Date

03/31/2012

Effective Date

02/27/2013

Expiration Date

03/31/2014

City

CHICAGO

State

Zip

60619

County

COOK

Ever Disciplined

LastModifiedDate

05/06/2014