BRETT ALLISON FULKS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049150256

License Status

NOT RENEWED

Business

First Name

BRETT

Middle

ALLISON

Last Name

FULKS

Business Name

BRETT ALLISON FULKS

Original Issue Date

08/22/2003

Effective Date

03/03/2009

Expiration Date

03/31/2010

City

MAHOMET

State

Zip

61853

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

05/04/2010