BRIAN J PERVENECKIS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049138177

License Status

NOT RENEWED

Business

First Name

BRIAN

Middle

Last Name

PERVENECKIS

Business Name

BRIAN J PERVENECKIS

Original Issue Date

09/12/2001

Effective Date

09/12/2001

Expiration Date

03/31/2002

City

CARBONDALE

State

Zip

62901

County

JACKSON

Ever Disciplined

LastModifiedDate

12/06/2005