SAMUEL DEAN GAINES Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049124514

License Status

NOT RENEWED

Business

First Name

SAMUEL

Middle

DEAN

Last Name

GAINES

Business Name

SAMUEL DEAN GAINES

Original Issue Date

01/22/1999

Effective Date

01/22/1999

Expiration Date

03/31/2000

City

MATTOON

State

Zip

61938

County

COLES

Ever Disciplined

LastModifiedDate

10/21/2005