TERESA M DAVENPORT Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049120730

License Status

NOT RENEWED

Business

First Name

TERESA

Middle

Last Name

DAVENPORT

Business Name

TERESA M DAVENPORT

Original Issue Date

04/22/1998

Effective Date

04/22/1998

Expiration Date

03/31/1999

City

SPRINGFIELD

State

Zip

62707

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/17/2005