TAMMY LATRICE BERGMAN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049255155

License Status

NOT RENEWED

Business

First Name

TAMMY

Middle

LATRICE

Last Name

BERGMAN

Business Name

TAMMY LATRICE BERGMAN

Original Issue Date

12/22/2017

Effective Date

03/11/2019

Expiration Date

09/30/2020

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Ever Disciplined

LastModifiedDate

01/08/2021