AS-SITA DE IVORY BAMBA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049262669

License Status

NOT RENEWED

Business

First Name

AS-SITA

Middle

DE IVORY

Last Name

BAMBA

Business Name

AS-SITA DE IVORY BAMBA

Original Issue Date

01/10/2019

Effective Date

01/10/2019

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60628

County

COOK

Ever Disciplined

LastModifiedDate

01/08/2021