DIANNA M BLACK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049107093

License Status

NOT RENEWED

Business

First Name

DIANNA

Middle

Last Name

BLACK

Business Name

DIANNA M BLACK

Original Issue Date

06/06/1994

Effective Date

06/06/1994

Expiration Date

03/31/1999

City

LOVINGTON

State

Zip

61937

County

MOULTRIE

Ever Disciplined

LastModifiedDate

10/17/2005