MARK ALLEN EAGAN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049146162

License Status

NOT RENEWED

Business

First Name

MARK

Middle

ALLEN

Last Name

EAGAN

Business Name

MARK ALLEN EAGAN

Original Issue Date

12/02/2002

Effective Date

12/02/2002

Expiration Date

03/31/2005

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/20/2005