CONNIE G VANDIVER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049141235

License Status

NOT RENEWED

Business

First Name

CONNIE

Middle

Last Name

VANDIVER

Business Name

CONNIE G VANDIVER

Original Issue Date

03/06/2002

Effective Date

03/06/2002

Expiration Date

03/31/2004

City

LYONS

State

Zip

60534

County

COOK

Ever Disciplined

LastModifiedDate

10/20/2005