BRENT LEE TACKITT Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049148898

License Status

NOT RENEWED

Business

First Name

BRENT

Middle

LEE

Last Name

TACKITT

Business Name

BRENT LEE TACKITT

Original Issue Date

06/13/2003

Effective Date

06/13/2003

Expiration Date

03/31/2004

City

FLORA

State

Zip

62839

County

CLAY

Ever Disciplined

LastModifiedDate

10/20/2005