LISA L TIDWELL - Pharmacist License in Illinois | # 049110838

LISA L TIDWELL

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049110838

License Status

NOT RENEWED

Business

N

First Name

LISA L

Last Name

TIDWELL

Business Name

LISA L TIDWELL

Original Issue Date

06/14/1995

Effective Date

06/14/1995

Expiration Date

03/31/2004

State

IL

Ever Disciplined

N

LastModifiedDate

10/20/2005