ERIC TERRENCE VAN VALKENBURG Pharmacist License verification

ERIC TERRENCE VAN VALKENBURG

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049154726

License Status

NOT RENEWED

Business

First Name

ERIC

Middle

TERRENCE

Last Name

VAN VALKENBURG

Business Name

ERIC TERRENCE VAN VALKENBURG

Original Issue Date

06/02/2004

Effective Date

03/17/2010

Expiration Date

03/31/2011

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/21/2011

Case Number

2010009538

Action

Refuse To Renew

Discipline Start Date

10/21/2011

Discipline Reason

after he diverted controlled substances from his former pharmacy employer for a period of approximately one year ending on or about October 20, 2010, and that he sold said drugs to another individual.