GERALD A STORM Pharmacist License verification

Business Entity

CANCELLED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049057581

License Status

CANCELLED

Business

First Name

GERALD A

Last Name

STORM

Business Name

GERALD A STORM

Original Issue Date

04/01/1972

Effective Date

04/01/1972

Expiration Date

01/01/1997

City

PEORIA

State

Zip

61604

County

PEORIA

Ever Disciplined

LastModifiedDate

10/17/2005