Shantel L Forman
ExpiredIllinois license 049210975
License
- Licensed by
- Illinois Department of Financial and Professional Regulation
- License number
- 049210975
- Status
- Expired (Not Renewed)
- First issued
- May 11, 2012
- Expired
- March 31, 2013
- License holder
- Shantel L Forman
- Entity type
- Individual
Classifications
- Pharmacy Technician Pharmacy
More from the license record
- Current term began
- 05/11/2012
Contact
Country Club Hills, IL 60478
Cook County