DIANA L SPARKS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049153049

License Status

NOT RENEWED

Business

First Name

DIANA

Middle

Last Name

SPARKS

Business Name

DIANA L SPARKS

Original Issue Date

01/29/2004

Effective Date

01/29/2004

Expiration Date

03/31/2005

City

CHILLICOTHE

State

Zip

61523

County

PEORIA

Ever Disciplined

LastModifiedDate

10/20/2005