LACEY NICOLE LEWIS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049138001

License Status

NOT RENEWED

Business

First Name

LACEY

Middle

NICOLE

Last Name

LEWIS

Business Name

LACEY NICOLE LEWIS

Original Issue Date

09/10/2001

Effective Date

09/10/2001

Expiration Date

03/31/2005

City

RANTOUL

State

Zip

61866

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

10/20/2005