ELLEN M PETERSEN Pharmacist License verification

Business Entity

INACTIVE

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051024177

License Status

INACTIVE

Business

First Name

ELLEN M

Last Name

PETERSEN

Business Name

ELLEN M PETERSEN

Original Issue Date

01/01/1997

Expiration Date

03/31/1986

City

PALOS HEIGHTS

State

Zip

60463

County

COOK

Ever Disciplined

LastModifiedDate

10/17/2005