SAMANTHA M POLEN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049216199

License Status

NOT RENEWED

Business

First Name

SAMANTHA

Middle

Last Name

POLEN

Business Name

SAMANTHA M POLEN

Original Issue Date

02/25/2013

Effective Date

03/19/2014

Expiration Date

03/31/2015

City

CHICAGO

State

Zip

60636

County

COOK

Ever Disciplined

LastModifiedDate

05/11/2015