ROSS MASON BLUE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049152322

License Status

NOT RENEWED

Business

First Name

ROSS

Middle

MASON

Last Name

BLUE

Business Name

ROSS MASON BLUE

Original Issue Date

12/03/2003

Effective Date

12/03/2003

Expiration Date

03/31/2005

City

SOUTH BELOIT

State

Zip

61080

County

BOONE

Ever Disciplined

LastModifiedDate

10/20/2005