TRACIE JOELLYN BLACK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049101208

License Status

NOT RENEWED

Business

First Name

TRACIE JOELLYN

Last Name

BLACK

Business Name

TRACIE JOELLYN BLACK

Original Issue Date

09/11/1992

Effective Date

09/11/1992

Expiration Date

03/31/1994

City

CARBONDALE

State

Zip

62901

County

JACKSON

Ever Disciplined

LastModifiedDate

10/17/2005