HOLLY BURGESS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049062664

License Status

NOT RENEWED

Business

First Name

HOLLY

Last Name

BURGESS

Business Name

HOLLY BURGESS

Original Issue Date

12/13/1974

Effective Date

12/13/1974

Expiration Date

01/01/1997

City

MATTOON

State

Zip

61938

County

COLES

Ever Disciplined

LastModifiedDate

10/17/2005