SUSAN NIEKAMP Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049060371

License Status

NOT RENEWED

Business

First Name

SUSAN

Last Name

NIEKAMP

Business Name

SUSAN NIEKAMP

Original Issue Date

10/05/1973

Effective Date

10/05/1973

Expiration Date

01/01/1997

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/17/2005