DIANE SUE PUCKETT Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049128958

License Status

NOT RENEWED

Business

First Name

DIANE

Middle

SUE

Last Name

PUCKETT

Business Name

DIANE SUE PUCKETT

Original Issue Date

01/14/2000

Effective Date

01/14/2000

Expiration Date

03/31/2002

City

SPRINGFIELD

State

Zip

62707

County

SANGAMON

Ever Disciplined

LastModifiedDate

12/06/2005