Lavontaine T Wirth
ExpiredIllinois license 049220679
License
- Licensed by
- Illinois Department of Financial and Professional Regulation
- License number
- 049220679
- Status
- Expired (Not Renewed)
- First issued
- September 9, 2013
- Expired
- March 31, 2015
- License holder
- Lavontaine T Wirth
- Entity type
- Individual
Classifications
- Pharmacy Technician Pharmacy
More from the license record
- Current term began
- 03/11/2014
Contact
Murphysboro, IL 62966
Jackson County