MARY ANN SOUTHARD Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049141104

License Status

NOT RENEWED

Business

First Name

MARY

Middle

ANN

Last Name

SOUTHARD

Business Name

MARY ANN SOUTHARD

Original Issue Date

03/01/2002

Effective Date

06/18/2015

Expiration Date

03/31/2016

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/20/2016