MARY ROSS SOUTHWORTH Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051040916

License Status

NOT RENEWED

Business

First Name

MARY ROSS

Last Name

SOUTHWORTH

Business Name

MARY ROSS SOUTHWORTH

Original Issue Date

08/12/1996

Effective Date

03/31/2004

Expiration Date

03/31/2006

City

WHEATON

State

Zip

60187

County

DUPAGE

Ever Disciplined

LastModifiedDate

05/11/2006