DAVID W LANE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049077403

License Status

NOT RENEWED

Business

First Name

DAVID W

Last Name

LANE

Business Name

DAVID W LANE

Original Issue Date

11/19/1982

Effective Date

11/19/1982

Expiration Date

03/31/1984

City

PEORIA HEIGHTS

State

Zip

61614

County

PEORIA

Ever Disciplined

LastModifiedDate

10/17/2005