DOUGLAS ALAN BURGE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049139880

License Status

NOT RENEWED

Business

First Name

DOUGLAS

Middle

ALAN

Last Name

BURGE

Business Name

DOUGLAS ALAN BURGE

Original Issue Date

01/09/2002

Effective Date

01/09/2002

Expiration Date

03/31/2004

City

DIVERNON

State

Zip

62530

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/20/2005