LORI M BASS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049110410

License Status

NOT RENEWED

Business

First Name

LORI

Middle

Last Name

BASS

Business Name

LORI M BASS

Original Issue Date

05/08/1995

Effective Date

05/08/1995

Expiration Date

03/31/2000

City

SALEM

State

Zip

62881

County

MARION

Ever Disciplined

LastModifiedDate

10/21/2005