REVIDIASA SEMANJAKU Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049215144

License Status

NOT RENEWED

Business

First Name

REVIDIASA

Last Name

SEMANJAKU

Prefix

Business Name

REVIDIASA SEMANJAKU

Original Issue Date

12/22/2012

Effective Date

12/22/2012

Expiration Date

03/31/2013

City

HARWOOD HEIGHTS

State

Zip

60706

County

COOK

Ever Disciplined

LastModifiedDate

05/06/2013