LAYNE DARICE ALE MOORE Pharmacist License verification

Business Entity

CANCELLED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049058096

License Status

CANCELLED

Business

First Name

LAYNE DARICE ALE

Last Name

MOORE

Business Name

LAYNE DARICE ALE MOORE

Original Issue Date

07/15/1972

Effective Date

07/15/1972

Expiration Date

01/01/1997

City

RANTOUL

State

Zip

61866

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

10/17/2005