MARY L DEFAZIO Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049264256

License Status

NOT RENEWED

Business

First Name

MARY

Middle

Last Name

DEFAZIO

Business Name

MARY L DEFAZIO

Original Issue Date

04/09/2019

Effective Date

04/09/2019

Expiration Date

09/30/2020

City

MUNDELEIN

State

Zip

60060

County

LAKE

Ever Disciplined

LastModifiedDate

01/08/2021