DIANN MICHELLE MOAD Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049139333

License Status

NOT RENEWED

Business

First Name

DIANN

Middle

MICHELLE

Last Name

MOAD

Business Name

DIANN MICHELLE MOAD

Original Issue Date

11/27/2001

Effective Date

11/27/2001

Expiration Date

03/31/2006

City

COLLINSVILLE

State

Zip

62234

County

MADISON

Ever Disciplined

LastModifiedDate

05/11/2006