DANIEL WESLEY DICKERSON Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049154466

License Status

NOT RENEWED

Business

First Name

DANIEL

Middle

WESLEY

Last Name

DICKERSON

Business Name

DANIEL WESLEY DICKERSON

Original Issue Date

05/21/2004

Effective Date

05/21/2004

Expiration Date

03/31/2005

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/20/2005