SHANAN S FERGUSON Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049138568

License Status

NOT RENEWED

Business

First Name

SHANAN

Middle

Last Name

FERGUSON

Business Name

SHANAN S FERGUSON

Original Issue Date

10/04/2001

Effective Date

10/04/2001

Expiration Date

03/31/2002

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Ever Disciplined

LastModifiedDate

12/06/2005