DERRICK J GOEN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049089254

License Status

NOT RENEWED

Business

First Name

DERRICK J

Last Name

GOEN

Business Name

DERRICK J GOEN

Original Issue Date

03/18/1989

Effective Date

03/18/1989

Expiration Date

03/31/1995

City

CHAMPAIGN

State

Zip

61824

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

10/17/2005