JOHANNA RENE BLACK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049113391

License Status

NOT RENEWED

Business

First Name

JOHANNA RENE

Last Name

BLACK

Business Name

JOHANNA RENE BLACK

Original Issue Date

02/14/1996

Effective Date

02/14/1996

Expiration Date

03/31/1997

City

STERLING

State

Zip

61081

County

WHITESIDE

Ever Disciplined

LastModifiedDate

10/17/2005