SANDRAA ELLEN FIELDS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049156025

License Status

NOT RENEWED

Business

First Name

SANDRAA

Middle

ELLEN

Last Name

FIELDS

Business Name

SANDRAA ELLEN FIELDS

Original Issue Date

07/09/2004

Effective Date

07/19/2016

Expiration Date

03/31/2017

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Ever Disciplined

LastModifiedDate

05/10/2017