LISA MARIE LARSON Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049120300

License Status

NOT RENEWED

Business

First Name

LISA

Middle

MARIE

Last Name

LARSON

Business Name

LISA MARIE LARSON

Original Issue Date

03/19/1998

Effective Date

03/19/1998

Expiration Date

03/31/2002

City

GALESBURG

State

Zip

61401

County

KNOX

Ever Disciplined

LastModifiedDate

12/06/2005