AUDREY MAXINE SAMUELS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049125262

License Status

NOT RENEWED

Business

First Name

AUDREY

Middle

MAXINE

Last Name

SAMUELS

Business Name

AUDREY MAXINE SAMUELS

Original Issue Date

04/02/1999

Effective Date

04/02/1999

Expiration Date

03/31/2000

City

PEORIA

State

Zip

61605

County

PEORIA

Ever Disciplined

LastModifiedDate

10/21/2005