ROBERTA LYNN MONTOYA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049148210

License Status

NOT RENEWED

Business

First Name

ROBERTA

Middle

LYNN

Last Name

MONTOYA

Business Name

ROBERTA LYNN MONTOYA

Original Issue Date

04/18/2003

Effective Date

04/18/2003

Expiration Date

03/31/2005

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/20/2005