DIANNE KATHLEEN VALLEJO Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049140480

License Status

NOT RENEWED

Business

First Name

DIANNE

Middle

KATHLEEN

Last Name

VALLEJO

Business Name

DIANNE KATHLEEN VALLEJO

Original Issue Date

02/04/2002

Effective Date

02/04/2002

Expiration Date

03/31/2005

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Ever Disciplined

LastModifiedDate

10/20/2005