EVAN MARTIN DEROSE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049261826

License Status

NOT RENEWED

Business

First Name

EVAN

Middle

MARTIN

Last Name

DEROSE

Business Name

EVAN MARTIN DEROSE

Original Issue Date

12/03/2018

Effective Date

02/20/2019

Expiration Date

09/30/2020

City

WAUKEGAN

State

Zip

60085

County

LAKE

Ever Disciplined

LastModifiedDate

01/08/2021