Pharmacist
PHARMACY TECHNICIAN
049306522
NOT RENEWED
N
SYDNEY
P
DIVAN
SYDNEY P DIVAN
10/07/2023
03/28/2024
03/31/2025
ROCKFORD
IL
61108
WINNEBAGO
Y
07/08/2025
2024006158
Suspension
09/23/2024
Failure to file and/or pay Illinois state income taxes.