MATTHEW R LANE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049146889

License Status

NOT RENEWED

Business

First Name

MATTHEW

Middle

Last Name

LANE

Business Name

MATTHEW R LANE

Original Issue Date

01/31/2003

Effective Date

03/31/2010

Expiration Date

03/31/2011

City

PEORIA

State

Zip

61604

County

PEORIA

Ever Disciplined

LastModifiedDate

05/12/2011