BRIAN J BAUTISTA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051287740

License Status

NOT RENEWED

Business

First Name

BRIAN

Middle

Last Name

BAUTISTA

Business Name

BRIAN J BAUTISTA

Original Issue Date

08/08/2000

Effective Date

03/19/2012

Expiration Date

03/31/2014

City

MUNDELEIN

State

Zip

60060

County

LAKE

Ever Disciplined

LastModifiedDate

05/06/2014