MYSSIE M FORCUM Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049110866

License Status

NOT RENEWED

Business

First Name

MYSSIE M

Last Name

FORCUM

Business Name

MYSSIE M FORCUM

Original Issue Date

06/15/1995

Effective Date

06/15/1995

Expiration Date

03/31/1999

City

SPARTA

State

Zip

62286

County

RANDOLPH

Ever Disciplined

LastModifiedDate

10/17/2005