TIM A HOUSEHOLDER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049155600

License Status

NOT RENEWED

Business

First Name

TIM

Middle

Last Name

HOUSEHOLDER

Business Name

TIM A HOUSEHOLDER

Original Issue Date

06/23/2004

Effective Date

06/23/2004

Expiration Date

03/31/2006

City

CHATHAM

State

Zip

62629

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/11/2006