TYSA SUZANNE FUNDEL Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049062191

License Status

NOT RENEWED

Business

First Name

TYSA SUZANNE

Last Name

FUNDEL

Business Name

TYSA SUZANNE FUNDEL

Original Issue Date

09/06/1974

Effective Date

09/06/1974

Expiration Date

01/01/1997

City

JACKSONVILLE

State

Zip

62650

County

MORGAN

Ever Disciplined

LastModifiedDate

10/17/2005