MICHAEL ANTHONY DEFAZIO Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049271746

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

ANTHONY

Last Name

DEFAZIO

Business Name

MICHAEL ANTHONY DEFAZIO

Original Issue Date

03/24/2020

Effective Date

03/24/2020

Expiration Date

03/31/2021

City

PEKIN

State

Zip

61554

County

TAZEWELL

Ever Disciplined

LastModifiedDate

07/20/2021