NATHAN DWAYNE HART Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049133390

License Status

NOT RENEWED

Business

First Name

NATHAN

Middle

DWAYNE

Last Name

HART

Business Name

NATHAN DWAYNE HART

Original Issue Date

10/30/2000

Effective Date

10/30/2000

Expiration Date

03/31/2001

City

CARLINVILLE

State

Zip

62626

County

MACOUPIN

Ever Disciplined

LastModifiedDate

10/21/2005