TIA LAVERN MACK - Pharmacist License in Illinois | # 049296280

TIA LAVERN MACK

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049296280

License Status

NOT RENEWED

Business

N

First Name

TIA

Middle

LAVERN

Last Name

MACK

Business Name

TIA LAVERN MACK

Original Issue Date

09/30/2022

Effective Date

09/30/2022

Expiration Date

03/31/2023

State

IL

Ever Disciplined

N

LastModifiedDate

09/07/2023