INDRA MOHANAM Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049136699

License Status

NOT RENEWED

Business

First Name

INDRA

Last Name

MOHANAM

Business Name

INDRA MOHANAM

Original Issue Date

06/13/2001

Effective Date

01/28/2014

Expiration Date

03/31/2015

City

PEORIA

State

Zip

61615

County

PEORIA

Ever Disciplined

LastModifiedDate

05/11/2015