ALICIA A FAIRBANKS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049154107

License Status

NOT RENEWED

Business

First Name

ALICIA

Middle

Last Name

FAIRBANKS

Business Name

ALICIA A FAIRBANKS

Original Issue Date

04/19/2004

Effective Date

04/19/2004

Expiration Date

03/31/2005

City

GLEN CARBON

State

Zip

62034

County

MADISON

Ever Disciplined

LastModifiedDate

10/20/2005