STACY LEE PONUKUMATLA Pharmacist License verification

Business Entity

ACTIVE

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051299400

License Status

ACTIVE

Business

First Name

STACY

Middle

LEE

Last Name

PONUKUMATLA

Business Name

STACY LEE PONUKUMATLA

Original Issue Date

05/05/2016

Effective Date

03/13/2024

Expiration Date

03/31/2026

City

GRAYSLAKE

State

Zip

60030

County

LAKE

Ever Disciplined

LastModifiedDate

01/30/2026