ETHAN J MARAVILLA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049278840

License Status

NOT RENEWED

Business

First Name

ETHAN

Middle

Last Name

MARAVILLA

Business Name

ETHAN J MARAVILLA

Original Issue Date

01/22/2021

Effective Date

01/22/2021

Expiration Date

05/31/2022

City

MUNDELEIN

State

Zip

60060

County

LAKE

Ever Disciplined

LastModifiedDate

07/27/2022