TYLEN SHANAE DIXON Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049128070

License Status

NOT RENEWED

Business

First Name

TYLEN

Middle

SHANAE

Last Name

DIXON

Business Name

TYLEN SHANAE DIXON

Original Issue Date

10/28/1999

Effective Date

10/28/1999

Expiration Date

03/31/2002

City

EAST ST LOUIS

State

Zip

62203

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

12/06/2005