PAMELA ANNE GALLIVAN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049062407

License Status

NOT RENEWED

Business

First Name

PAMELA ANNE

Last Name

GALLIVAN

Business Name

PAMELA ANNE GALLIVAN

Original Issue Date

10/18/1974

Effective Date

10/18/1974

Expiration Date

01/01/1997

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

10/17/2005