PAT R MOULTRIE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049101577

License Status

NOT RENEWED

Business

First Name

PAT R

Last Name

MOULTRIE

Business Name

PAT R MOULTRIE

Original Issue Date

10/22/1992

Effective Date

10/22/1992

Expiration Date

03/31/2003

City

STAUNTON

State

Zip

62088

County

MACOUPIN

Ever Disciplined

LastModifiedDate

10/20/2005