STEPHEN ELLIOTT BURNSIDE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049055804

License Status

NOT RENEWED

Business

First Name

STEPHEN ELLIOTT

Last Name

BURNSIDE

Business Name

STEPHEN ELLIOTT BURNSIDE

Original Issue Date

01/01/1997

Expiration Date

03/31/1986

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

10/17/2005