LISA DIANE NICOLOFF Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049153838

License Status

NOT RENEWED

Business

First Name

LISA

Middle

DIANE

Last Name

NICOLOFF

Business Name

LISA DIANE NICOLOFF

Original Issue Date

03/22/2004

Effective Date

03/22/2004

Expiration Date

03/31/2005

City

TROY

State

Zip

62294

County

MADISON

Ever Disciplined

LastModifiedDate

10/20/2005