SHAUN DANIEL CUSACK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049122367

License Status

NOT RENEWED

Business

First Name

SHAUN

Middle

DANIEL

Last Name

CUSACK

Business Name

SHAUN DANIEL CUSACK

Original Issue Date

08/07/1998

Effective Date

08/07/1998

Expiration Date

03/31/2000

City

PEORIA

State

Zip

61615

County

PEORIA

Ever Disciplined

LastModifiedDate

10/21/2005