MARK S GOODWIN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049153629

License Status

NOT RENEWED

Business

First Name

MARK

Middle

Last Name

GOODWIN

Business Name

MARK S GOODWIN

Original Issue Date

03/15/2004

Effective Date

03/15/2004

Expiration Date

03/31/2006

City

CHATHAM

State

Zip

62629

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/11/2006