TIFFANY L DAVENPORT - Pharmacist License in Illinois | # 049154826

TIFFANY L DAVENPORT

Business Entity

INACTIVE

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049154826

License Status

INACTIVE

Business

N

First Name

TIFFANY

Middle

L

Last Name

DAVENPORT

Business Name

TIFFANY L DAVENPORT

Original Issue Date

06/08/2004

Effective Date

03/19/2021

Expiration Date

05/31/2022

State

IL

Ever Disciplined

N

LastModifiedDate

02/28/2022