ETHAN J DECOTA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051299675

License Status

NOT RENEWED

Business

First Name

ETHAN

Middle

Last Name

DECOTA

Prefix

Business Name

ETHAN J DECOTA

Original Issue Date

08/04/2016

Effective Date

03/26/2018

Expiration Date

09/30/2020

City

EUREKA

State

Zip

95503

County

COOK

Ever Disciplined

LastModifiedDate

01/14/2021