SHANNON S GERGEN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049129461

License Status

NOT RENEWED

Business

First Name

SHANNON

Middle

Last Name

GERGEN

Business Name

SHANNON S GERGEN

Original Issue Date

02/22/2000

Effective Date

02/22/2000

Expiration Date

03/31/2005

City

GRANITE CITY

State

Zip

62040

County

MADISON

Ever Disciplined

LastModifiedDate

10/20/2005