LACRESHA DIANE DAVIS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049138434

License Status

NOT RENEWED

Business

First Name

LACRESHA

Middle

DIANE

Last Name

DAVIS

Business Name

LACRESHA DIANE DAVIS

Original Issue Date

09/25/2001

Effective Date

09/25/2001

Expiration Date

03/31/2002

City

ROCKFORD

State

Zip

61102

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

12/06/2005