KIMBERLY ANN GUSTAFSON Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049106604

License Status

NOT RENEWED

Business

First Name

KIMBERLY ANN

Last Name

GUSTAFSON

Business Name

KIMBERLY ANN GUSTAFSON

Original Issue Date

04/18/1994

Effective Date

04/18/1994

Expiration Date

03/31/1996

City

RANTOUL

State

Zip

61866

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

10/17/2005