TIA LAVERN MACK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049296280

License Status

NOT RENEWED

Business

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

City

CHICAGO

State

Zip

60628

County

ADAMS

Ever Disciplined

LastModifiedDate

09/07/2023