LISA M BROACH Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049143511

License Status

NOT RENEWED

Business

First Name

LISA

Middle

Last Name

BROACH

Business Name

LISA M BROACH

Original Issue Date

07/03/2002

Effective Date

07/03/2002

Expiration Date

03/31/2004

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/20/2005