DAVID MICHAEL LACY Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049153499

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

MICHAEL

Last Name

LACY

Business Name

DAVID MICHAEL LACY

Original Issue Date

03/09/2004

Effective Date

03/20/2014

Expiration Date

03/31/2015

City

ROCHESTER

State

Zip

62563

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/11/2015