BRANDON DOUGLAS ALT Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049140785

License Status

NOT RENEWED

Business

First Name

BRANDON

Middle

DOUGLAS

Last Name

ALT

Business Name

BRANDON DOUGLAS ALT

Original Issue Date

02/20/2002

Effective Date

02/20/2002

Expiration Date

03/31/2004

City

ROCK ISLAND

State

Zip

61201

County

ROCK ISLAND

Ever Disciplined

LastModifiedDate

10/20/2005