FEDAA M BALLOUTA Pharmacist License verification

Business Entity

ACTIVE

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051302641

License Status

ACTIVE

Business

First Name

FEDAA

Middle

Last Name

BALLOUTA

Business Name

FEDAA M BALLOUTA

Original Issue Date

10/04/2019

Effective Date

02/22/2026

Expiration Date

03/31/2028

City

ORLAND PARK

State

Zip

60467

Ever Disciplined

LastModifiedDate

02/22/2026