SHOSHANNA LEAH BAUER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049152759

License Status

NOT RENEWED

Business

First Name

SHOSHANNA

Middle

LEAH

Last Name

BAUER

Business Name

SHOSHANNA LEAH BAUER

Original Issue Date

01/02/2004

Effective Date

01/02/2004

Expiration Date

03/31/2005

City

CHAMPAIGN

State

Zip

61821

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

10/20/2005