ROGER E LONG Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049123458

License Status

NOT RENEWED

Business

First Name

ROGER

Middle

Last Name

LONG

Business Name

ROGER E LONG

Original Issue Date

10/28/1998

Effective Date

10/28/1998

Expiration Date

03/31/2005

City

ROCKFORD

State

Zip

61109

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/20/2005