FULLERTON WESTERN PROFESSIONAL PHARM Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

LICENSED CONTROLLED PHARMACY SUBSTANCE

License Number

32*****10

License Status

NOT RENEWED

Business

Business Name

FULLERTON WESTERN PROFESSIONAL PHARM

Original Issue Date

04/03/1986

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

CHICAGO

State

Zip

60647

County

COOK

Specialty/Qualifier

Hospital/Clinic

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/04/2010

Case Number

1986000129

Action

Probation

Discipline Start Date

08/27/1990

Discipline End Date

08/27/1991