DIANNA M MALCOM - Pharmacist License in Illinois | # 049229090

DIANNA M MALCOM

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049229090

License Status

NOT RENEWED

Business

N

First Name

DIANNA

Middle

M

Last Name

MALCOM

Prefix

MR

Business Name

DIANNA M MALCOM

Original Issue Date

11/07/2014

Effective Date

11/07/2014

Expiration Date

03/31/2015

State

IL

Ever Disciplined

N

LastModifiedDate

05/11/2015