REGINA E PARK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049144937

License Status

NOT RENEWED

Business

First Name

REGINA

Middle

Last Name

PARK

Business Name

REGINA E PARK

Original Issue Date

09/30/2002

Effective Date

09/30/2002

Expiration Date

03/31/2005

City

PEORIA

State

Zip

61615

County

PEORIA

Ever Disciplined

LastModifiedDate

10/20/2005