JENNIFER DIANE VANDERMYDE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049116424

License Status

NOT RENEWED

Business

First Name

JENNIFER DIANE

Last Name

VANDERMYDE

Business Name

JENNIFER DIANE VANDERMYDE

Original Issue Date

01/31/1997

Effective Date

01/31/1997

Expiration Date

03/31/2002

City

EUREKA

State

Zip

61530

County

WOODFORD

Ever Disciplined

LastModifiedDate

12/06/2005