TERRY BAST Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049070583

License Status

NOT RENEWED

Business

First Name

TERRY

Last Name

BAST

Business Name

TERRY BAST

Original Issue Date

01/26/1979

Effective Date

01/26/1979

Expiration Date

01/01/1997

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Ever Disciplined

LastModifiedDate

10/17/2005