DIANA REYES BAUTISTA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049109937

License Status

NOT RENEWED

Business

First Name

DIANA REYES

Last Name

BAUTISTA

Business Name

DIANA REYES BAUTISTA

Original Issue Date

03/29/1995

Effective Date

01/19/2006

Expiration Date

03/31/2007

City

ROCKFORD

State

Zip

61101

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/14/2007