SHANNON R LANE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049106204

License Status

NOT RENEWED

Business

First Name

SHANNON

Middle

Last Name

LANE

Business Name

SHANNON R LANE

Original Issue Date

03/10/1994

Effective Date

03/10/1994

Expiration Date

03/31/1995

City

BLOOMINGTOM

State

Zip

61704

Ever Disciplined

LastModifiedDate

10/17/2005