ANGELA R BLACK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049145490

License Status

NOT RENEWED

Business

First Name

ANGELA

Middle

Last Name

BLACK

Business Name

ANGELA R BLACK

Original Issue Date

10/24/2002

Effective Date

10/24/2002

Expiration Date

03/31/2004

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/20/2005