SHAYNE M ROTH Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049111847

License Status

NOT RENEWED

Business

First Name

SHAYNE M

Last Name

ROTH

Business Name

SHAYNE M ROTH

Original Issue Date

09/19/1995

Effective Date

09/19/1995

Expiration Date

03/31/1996

City

MILLSTADT

State

Zip

62260

County

DUPAGE

Ever Disciplined

LastModifiedDate

10/17/2005