ERIC ALLAN GUSTAFSON Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049132043

License Status

NOT RENEWED

Business

First Name

ERIC

Middle

ALLAN

Last Name

GUSTAFSON

Business Name

ERIC ALLAN GUSTAFSON

Original Issue Date

08/08/2000

Effective Date

08/08/2000

Expiration Date

03/31/2005

City

PEORIA

State

Zip

61604

County

PEORIA

Ever Disciplined

LastModifiedDate

10/20/2005