MARY MAE SULLIVAN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049059732

License Status

NOT RENEWED

Business

First Name

MARY MAE

Last Name

SULLIVAN

Business Name

MARY MAE SULLIVAN

Original Issue Date

06/15/1973

Effective Date

06/15/1973

Expiration Date

01/01/1997

City

GALESBURG

State

Zip

61401

County

KNOX

Ever Disciplined

LastModifiedDate

10/17/2005