GAYLE JEAN HERZOG Pharmacist License verification

Business Entity

INACTIVE

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049124184

License Status

INACTIVE

Business

First Name

GAYLE

Middle

JEAN

Last Name

HERZOG

Business Name

GAYLE JEAN HERZOG

Original Issue Date

12/17/1998

Effective Date

02/28/2013

Expiration Date

03/31/2014

City

PEORIA

State

Zip

61604

County

PEORIA

Ever Disciplined

LastModifiedDate

01/09/2014