NORTHWESTERN LAKE FOREST HOSPITAL Pharmacist License verification

Business Entity

CHANGE OF OWNERSHIP

License Type

Pharmacist

Description

LICENSED CONTROLLED PHARMACY SUBSTANCE

License Number

32*****68

License Status

CHANGE OF OWNERSHIP

Business

Business Name

NORTHWESTERN LAKE FOREST HOSPITAL

Original Issue Date

05/24/1996

Effective Date

02/08/2006

Expiration Date

03/31/2008

City

LAKE FOREST

State

Zip

60045

County

LAKE

Specialty/Qualifier

Hospital/Clinic

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/24/2006