SHANE T STACHURA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049153521

License Status

NOT RENEWED

Business

First Name

SHANE

Middle

Last Name

STACHURA

Business Name

SHANE T STACHURA

Original Issue Date

03/09/2004

Effective Date

03/09/2004

Expiration Date

03/31/2005

City

BUCKLEY

State

Zip

60918

County

IROQUOIS

Ever Disciplined

LastModifiedDate

10/20/2005