ROLLAINE MASON BLACK - Pharmacist License in Illinois | # 051022419

ROLLAINE MASON BLACK

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051022419

License Status

NOT RENEWED

Business

N

First Name

ROLLAINE MASON

Last Name

BLACK

Business Name

ROLLAINE MASON BLACK

Original Issue Date

01/01/1997

Expiration Date

03/31/1990

State

IL

Ever Disciplined

Y

LastModifiedDate

10/17/2005

Case Number

1986000127

Action

Suspension

Discipline Start Date

10/13/1989