VICKI LANE BLACK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049068973

License Status

NOT RENEWED

Business

First Name

VICKI LANE

Last Name

BLACK

Business Name

VICKI LANE BLACK

Original Issue Date

03/17/1978

Effective Date

03/17/1978

Expiration Date

01/01/1997

City

PONTIAC

State

Zip

61764

County

LIVINGSTON

Ever Disciplined

LastModifiedDate

10/17/2005