KATELYN P FORMAN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049241822

License Status

NOT RENEWED

Business

First Name

KATELYN

Middle

Last Name

FORMAN

Business Name

KATELYN P FORMAN

Original Issue Date

05/12/2016

Effective Date

05/12/2016

Expiration Date

03/31/2017

City

MCHENRY

State

Zip

60050

County

MCHENRY

Ever Disciplined

LastModifiedDate

05/10/2017