BRENT R COULLARD Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049149880

License Status

NOT RENEWED

Business

First Name

BRENT

Middle

Last Name

COULLARD

Business Name

BRENT R COULLARD

Original Issue Date

08/19/2003

Effective Date

03/06/2014

Expiration Date

03/31/2015

City

LAKE VILLA

State

Zip

60046

County

LAKE

Ever Disciplined

LastModifiedDate

05/11/2015