TRACI L GRANDSTAFF Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049123580

License Status

NOT RENEWED

Business

First Name

TRACI

Middle

Last Name

GRANDSTAFF

Business Name

TRACI L GRANDSTAFF

Original Issue Date

11/02/1998

Effective Date

11/02/1998

Expiration Date

03/31/2003

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/20/2005