PRATHIMA GHANTA SULLIVAN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049139275

License Status

NOT RENEWED

Business

First Name

PRATHIMA

Last Name

GHANTA SULLIVAN

Business Name

PRATHIMA GHANTA SULLIVAN

Original Issue Date

11/19/2001

Effective Date

11/19/2001

Expiration Date

03/31/2006

City

SPRINGFIELD

State

Zip

62707

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/11/2006