SHIBU RAPHAEL VAZHA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049142969

License Status

NOT RENEWED

Business

First Name

SHIBU

Middle

RAPHAEL

Last Name

VAZHA

Business Name

SHIBU RAPHAEL VAZHA

Original Issue Date

06/04/2002

Effective Date

06/04/2002

Expiration Date

03/31/2003

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/20/2005