DIANE P TILLOU Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049139624

License Status

NOT RENEWED

Business

First Name

DIANE

Middle

Last Name

TILLOU

Business Name

DIANE P TILLOU

Original Issue Date

12/18/2001

Effective Date

12/18/2001

Expiration Date

03/31/2003

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/20/2005