SHANNON LEE LARSON - Pharmacist License in Illinois | # 049144380

SHANNON LEE LARSON

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049144380

License Status

NOT RENEWED

Business

N

First Name

SHANNON

Middle

LEE

Last Name

LARSON

Business Name

SHANNON LEE LARSON

Original Issue Date

08/29/2002

Effective Date

08/29/2002

Expiration Date

03/31/2005

State

IL

Ever Disciplined

N

LastModifiedDate

10/20/2005