TINA M BOLIN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049140401

License Status

NOT RENEWED

Business

First Name

TINA

Middle

Last Name

BOLIN

Business Name

TINA M BOLIN

Original Issue Date

01/29/2002

Effective Date

01/29/2002

Expiration Date

03/31/2004

City

ROCKFORD

State

Zip

61102

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/20/2005