DAVID MICHAEL GOMEZ Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049139939

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

MICHAEL

Last Name

GOMEZ

Business Name

DAVID MICHAEL GOMEZ

Original Issue Date

01/11/2002

Effective Date

01/11/2002

Expiration Date

03/31/2003

City

LOVES PARK

State

Zip

61111

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/20/2005