CAROL DIANE LATTA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049127165

License Status

NOT RENEWED

Business

First Name

CAROL

Middle

DIANE

Last Name

LATTA

Business Name

CAROL DIANE LATTA

Original Issue Date

08/25/1999

Effective Date

08/25/1999

Expiration Date

03/31/2003

City

MASCOUTAH

State

Zip

62258

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

10/20/2005