MINDY SUSAN AMBROSE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049138876

License Status

NOT RENEWED

Business

First Name

MINDY

Middle

SUSAN

Last Name

AMBROSE

Business Name

MINDY SUSAN AMBROSE

Original Issue Date

10/30/2001

Effective Date

01/12/2018

Expiration Date

03/31/2019

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

07/15/2019