MARK ALAN FORTMAN - Pharmacist License in Illinois | # 051031587

MARK ALAN FORTMAN

Business Entity

INACTIVE

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051031587

License Status

INACTIVE

Business

N

First Name

MARK ALAN

Last Name

FORTMAN

Business Name

MARK ALAN FORTMAN

Original Issue Date

08/18/1977

Effective Date

02/02/2016

Expiration Date

03/31/2018

State

IL

Ever Disciplined

N

LastModifiedDate

01/12/2018