EVA JANE SOUTHERLAND Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049130173

License Status

NOT RENEWED

Business

First Name

EVA

Middle

JANE

Last Name

SOUTHERLAND

Business Name

EVA JANE SOUTHERLAND

Original Issue Date

03/22/2000

Effective Date

03/22/2000

Expiration Date

03/31/2004

City

DECATUR

State

Zip

62526

County

MACON

Ever Disciplined

LastModifiedDate

10/20/2005