ROBERTA DIANE BALLARD Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049054257

License Status

NOT RENEWED

Business

First Name

ROBERTA DIANE

Last Name

BALLARD

Business Name

ROBERTA DIANE BALLARD

Original Issue Date

01/01/1997

Expiration Date

03/31/1984

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Ever Disciplined

LastModifiedDate

10/17/2005