ANGELICA A DISTERHOFT Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049122349

License Status

NOT RENEWED

Business

First Name

ANGELICA

Middle

Last Name

DISTERHOFT

Business Name

ANGELICA A DISTERHOFT

Original Issue Date

08/06/1998

Effective Date

08/06/1998

Expiration Date

03/31/2005

City

GENESEO

State

Zip

61254

County

HENRY

Ever Disciplined

LastModifiedDate

10/20/2005