SUSAN L BALLARD Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049095200

License Status

NOT RENEWED

Business

First Name

SUSAN L

Last Name

BALLARD

Business Name

SUSAN L BALLARD

Original Issue Date

12/05/1990

Effective Date

12/05/1990

Expiration Date

03/31/1993

City

ROSCOE

State

Zip

61073

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/17/2005