SHANA ASHLEY MORTENSON Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049156090

License Status

NOT RENEWED

Business

First Name

SHANA

Middle

ASHLEY

Last Name

MORTENSON

Business Name

SHANA ASHLEY MORTENSON

Original Issue Date

07/13/2004

Effective Date

01/26/2009

Expiration Date

03/31/2010

City

JOHNSTON

State

Zip

50131

Ever Disciplined

LastModifiedDate

05/04/2010