Pharmacist
LICENSED DIVISION III PHARMACY
059011089
CHANGE OF OWNERSHIP
Y
VENCOR HOSPITAL CHICAGO
01/02/1992
01/02/1992
03/31/2000
NORTHLAKE
IL
60164
COOK
Y
10/19/2005
1991006210
Fine
01/10/1992
Failed to apply for change of pharmacy ownership and operated under non-renewed DEA registration.