GLEN LEWIS EZAKI Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051028744

License Status

NOT RENEWED

Business

First Name

GLEN LEWIS

Last Name

EZAKI

Business Name

GLEN LEWIS EZAKI

Original Issue Date

01/01/1997

Effective Date

01/15/2014

Expiration Date

03/31/2016

City

CHICAGO

State

Zip

60601

County

COOK

Ever Disciplined

LastModifiedDate

05/20/2016