MATTHEW BAUTISTA TANAWAN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049292890

License Status

NOT RENEWED

Business

First Name

MATTHEW

Middle

BAUTISTA

Last Name

TANAWAN

Business Name

MATTHEW BAUTISTA TANAWAN

Original Issue Date

06/01/2022

Effective Date

06/01/2022

Expiration Date

03/31/2023

City

CHICAGO

State

Zip

60618

County

COOK

Ever Disciplined

LastModifiedDate

09/07/2023