MICHELLE E MAYFIELD-BASKE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049126907

License Status

NOT RENEWED

Business

First Name

MICHELLE

Middle

Last Name

MAYFIELD-BASKE

Business Name

MICHELLE E MAYFIELD-BASKE

Original Issue Date

08/06/1999

Effective Date

08/06/1999

Expiration Date

03/31/2002

City

PEORIA

State

Zip

61614

County

PEORIA

Ever Disciplined

LastModifiedDate

12/06/2005