BENJAMIN DAVID MATHIS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049152766

License Status

NOT RENEWED

Business

First Name

BENJAMIN

Middle

DAVID

Last Name

MATHIS

Business Name

BENJAMIN DAVID MATHIS

Original Issue Date

01/02/2004

Effective Date

03/18/2009

Expiration Date

03/31/2010

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/04/2010