AMANDA J LEWIS DMD Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049118963

License Status

NOT RENEWED

Business

First Name

AMANDA

Middle

Last Name

LEWIS

Suffix

DMD

Business Name

AMANDA J LEWIS DMD

Original Issue Date

10/03/1997

Effective Date

10/03/1997

Expiration Date

03/31/2002

City

COAL VALLEY

State

Zip

61240

County

ROCK ISLAND

Ever Disciplined

LastModifiedDate

12/06/2005