SUSAN ELIZABETH FERNANDES Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049145814

License Status

NOT RENEWED

Business

First Name

SUSAN

Middle

ELIZABETH

Last Name

FERNANDES

Business Name

SUSAN ELIZABETH FERNANDES

Original Issue Date

11/13/2002

Effective Date

01/11/2007

Expiration Date

03/31/2008

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Ever Disciplined

LastModifiedDate

05/02/2008