BROOKE R MYLOTT Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049148439

License Status

NOT RENEWED

Business

First Name

BROOKE

Middle

Last Name

MYLOTT

Business Name

BROOKE R MYLOTT

Original Issue Date

05/06/2003

Effective Date

05/06/2003

Expiration Date

03/31/2005

City

WASHINGTON

State

Zip

61571

County

TAZEWELL

Ever Disciplined

LastModifiedDate

10/20/2005