SHANE MICHAEL MARTIN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049150082

License Status

NOT RENEWED

Business

First Name

SHANE

Middle

MICHAEL

Last Name

MARTIN

Business Name

SHANE MICHAEL MARTIN

Original Issue Date

08/21/2003

Effective Date

01/09/2007

Expiration Date

03/31/2008

City

PANAMA CITY

State

Zip

32405

Ever Disciplined

LastModifiedDate

05/02/2008