OTHA L COLLINS MOORE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049215814

License Status

NOT RENEWED

Business

First Name

OTHA

Middle

Last Name

COLLINS MOORE

Business Name

OTHA L COLLINS MOORE

Original Issue Date

01/31/2013

Effective Date

04/01/2014

Expiration Date

03/31/2015

City

CHICAGO

State

Zip

60628

County

COOK

Ever Disciplined

LastModifiedDate

05/11/2015