MARK PHYLLICIA SOVEREIGN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049211512

License Status

NOT RENEWED

Business

First Name

MARK

Middle

PHYLLICIA

Last Name

SOVEREIGN

Prefix

Business Name

MARK PHYLLICIA SOVEREIGN

Original Issue Date

06/05/2012

Effective Date

06/05/2012

Expiration Date

03/31/2013

City

SOUTH CHICAGO HEIGHTS

State

Zip

60411

County

COOK

Ever Disciplined

LastModifiedDate

05/06/2013