DIANE L EISSENS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049084647

License Status

NOT RENEWED

Business

First Name

DIANE L

Last Name

EISSENS

Business Name

DIANE L EISSENS

Original Issue Date

07/13/1987

Effective Date

07/13/1987

Expiration Date

03/31/1995

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/17/2005