STACI M LEWIS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049140181

License Status

NOT RENEWED

Business

First Name

STACI

Middle

Last Name

LEWIS

Business Name

STACI M LEWIS

Original Issue Date

01/17/2002

Effective Date

01/17/2002

Expiration Date

03/31/2003

City

LORAINE

State

Zip

62349

County

ADAMS

Ever Disciplined

LastModifiedDate

10/20/2005