SAMANTHA A HANSEN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049150826

License Status

NOT RENEWED

Business

First Name

SAMANTHA

Middle

Last Name

HANSEN

Business Name

SAMANTHA A HANSEN

Original Issue Date

09/24/2003

Effective Date

09/24/2003

Expiration Date

03/31/2005

City

PEORIA

State

Zip

61607

County

PEORIA

Ever Disciplined

LastModifiedDate

10/20/2005