ANASUYA S BRAHMAMDAM Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049142107

License Status

NOT RENEWED

Business

First Name

ANASUYA

Middle

Last Name

BRAHMAMDAM

Business Name

ANASUYA S BRAHMAMDAM

Original Issue Date

05/02/2002

Effective Date

01/09/2007

Expiration Date

03/31/2008

City

SPRINGFIELD

State

Zip

62711

County

SANGAMON

Ever Disciplined

LastModifiedDate

03/08/2012