TYKA R FULLER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049156335

License Status

NOT RENEWED

Business

First Name

TYKA

Middle

Last Name

FULLER

Business Name

TYKA R FULLER

Original Issue Date

07/29/2004

Effective Date

01/09/2007

Expiration Date

03/31/2008

City

COFFEEN

State

Zip

62017

County

MONTGOMERY

Ever Disciplined

LastModifiedDate

05/02/2008