MICHELLE RENAE SURVILLAS - Pharmacist License in Tennessee | # 049138797

MICHELLE RENAE SURVILLAS

Business Entity

INACTIVE

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049138797

License Status

INACTIVE

Business

N

First Name

MICHELLE

Middle

RENAE

Last Name

SURVILLAS

Business Name

MICHELLE RENAE SURVILLAS

Original Issue Date

10/23/2001

Effective Date

01/10/2008

Expiration Date

03/31/2009

State

TN

Ever Disciplined

N

LastModifiedDate

01/06/2009