SANJAY JAYANTI MODHERASURA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051286008

License Status

NOT RENEWED

Business

First Name

SANJAY

Middle

JAYANTI

Last Name

MODHERASURA

Business Name

SANJAY JAYANTI MODHERASURA

Original Issue Date

07/03/1997

Effective Date

01/04/2020

Expiration Date

07/31/2022

City

PLAINFIELD

State

Zip

60586

County

WILL

Ever Disciplined

LastModifiedDate

04/03/2025