DERICK LEE GROSS - Pharmacist License in Illinois | # 049235217

DERICK LEE GROSS

Business Entity

CANCELLED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049235217

License Status

CANCELLED

Business

N

First Name

DERICK

Middle

LEE

Last Name

GROSS

Business Name

DERICK LEE GROSS

Original Issue Date

08/04/2015

Effective Date

08/04/2015

Expiration Date

03/31/2016

State

IL

Ever Disciplined

N

LastModifiedDate

08/04/2015