LAUREN MICHELLE BAULOS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049143257

License Status

NOT RENEWED

Business

First Name

LAUREN

Middle

MICHELLE

Last Name

BAULOS

Business Name

LAUREN MICHELLE BAULOS

Original Issue Date

06/17/2002

Effective Date

06/17/2002

Expiration Date

03/31/2004

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/20/2005