SUSAN J DERHAM Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049083103

License Status

NOT RENEWED

Business

First Name

SUSAN J

Last Name

DERHAM

Business Name

SUSAN J DERHAM

Original Issue Date

07/31/1986

Effective Date

07/31/1986

Expiration Date

03/31/1988

City

CHARLESTON

State

Zip

61920

County

COLES

Ever Disciplined

LastModifiedDate

10/17/2005