DIANE M BALDUS Pharmacist License verification

Business Entity

CANCELLED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049064115

License Status

CANCELLED

Business

First Name

DIANE M

Last Name

BALDUS

Business Name

DIANE M BALDUS

Original Issue Date

09/05/1975

Effective Date

09/05/1975

Expiration Date

01/01/1997

City

FAIRVIEW HEIGHTS

State

Zip

62208

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

10/17/2005