MARTIN DAVENPORT Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049071872

License Status

NOT RENEWED

Business

First Name

MARTIN

Last Name

DAVENPORT

Business Name

MARTIN DAVENPORT

Original Issue Date

09/21/1979

Effective Date

09/21/1979

Expiration Date

01/01/1997

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Ever Disciplined

LastModifiedDate

10/17/2005