EDIAN BANUELOS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049210110

License Status

NOT RENEWED

Business

First Name

EDIAN

Last Name

BANUELOS

Prefix

Business Name

EDIAN BANUELOS

Original Issue Date

04/03/2012

Effective Date

01/22/2020

Expiration Date

03/31/2021

City

LAKEMOOR

State

Zip

60051

County

LAKE

Ever Disciplined

LastModifiedDate

07/20/2021