DARA DIANE PUCKEL Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049081196

License Status

NOT RENEWED

Business

First Name

DARA DIANE

Last Name

PUCKEL

Business Name

DARA DIANE PUCKEL

Original Issue Date

06/17/1985

Effective Date

06/17/1985

Expiration Date

03/31/1987

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/17/2005