STACY A ANDERSEN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049133121

License Status

NOT RENEWED

Business

First Name

STACY

Middle

Last Name

ANDERSEN

Business Name

STACY A ANDERSEN

Original Issue Date

10/13/2000

Effective Date

10/13/2000

Expiration Date

03/31/2001

City

JOHNSBURG

State

Zip

60051

County

MCHENRY

Ever Disciplined

LastModifiedDate

10/21/2005