AMANDA R LONG Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049153986

License Status

NOT RENEWED

Business

First Name

AMANDA

Middle

Last Name

LONG

Business Name

AMANDA R LONG

Original Issue Date

04/07/2004

Effective Date

01/09/2007

Expiration Date

03/31/2008

City

ALHAMBRA

State

Zip

62001

County

MADISON

Ever Disciplined

LastModifiedDate

05/02/2008