POONAM TANNA TRIVEDI Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049155505

License Status

NOT RENEWED

Business

First Name

POONAM

Middle

TANNA

Last Name

TRIVEDI

Business Name

POONAM TANNA TRIVEDI

Original Issue Date

06/22/2004

Effective Date

02/03/2011

Expiration Date

03/31/2012

City

PHOENIX

State

Zip

85022

Ever Disciplined

LastModifiedDate

05/07/2012