STACEY NICOLE JOHNSON Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049149643

License Status

NOT RENEWED

Business

First Name

STACEY

Middle

NICOLE

Last Name

JOHNSON

Business Name

STACEY NICOLE JOHNSON

Original Issue Date

07/29/2003

Effective Date

07/29/2003

Expiration Date

03/31/2005

City

DANVILLE

State

Zip

61832

County

VERMILION

Ever Disciplined

LastModifiedDate

10/20/2005