ANDREA C KOOISTRA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049121087

License Status

NOT RENEWED

Business

First Name

ANDREA

Middle

Last Name

KOOISTRA

Business Name

ANDREA C KOOISTRA

Original Issue Date

05/20/1998

Effective Date

05/20/1998

Expiration Date

03/31/1999

City

BELVIDERE

State

Zip

61008

County

BOONE

Ever Disciplined

LastModifiedDate

10/17/2005