CARRIE ELIZABETH GOFORTH Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049136620

License Status

NOT RENEWED

Business

First Name

CARRIE

Middle

ELIZABETH

Last Name

GOFORTH

Business Name

CARRIE ELIZABETH GOFORTH

Original Issue Date

06/07/2001

Effective Date

06/07/2001

Expiration Date

03/31/2003

City

COLLINSVILLE

State

Zip

62234

County

MADISON

Ever Disciplined

LastModifiedDate

10/20/2005