TERRY EUGENE SULLIVAN Pharmacist License verification

TERRY EUGENE SULLIVAN

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049153088

License Status

NOT RENEWED

Business

First Name

TERRY

Middle

EUGENE

Last Name

SULLIVAN

Business Name

TERRY EUGENE SULLIVAN

Original Issue Date

01/29/2004

Effective Date

01/13/2009

Expiration Date

03/31/2010

City

MAKANDA

State

Zip

62958

Ever Disciplined

LastModifiedDate

05/08/2012

Case Number

2011002524

Action

Suspension

Discipline Start Date

05/07/2012

Discipline Reason

due to diversion of controlled substances, legend drugs and an over-the-counter medication from his pharmacy employer for self use and, related to such, voluntarily surrendered his Missouri pharmacist license.