DAVID L PIVOVARNIK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049156396

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

Last Name

PIVOVARNIK

Business Name

DAVID L PIVOVARNIK

Original Issue Date

08/04/2004

Effective Date

01/19/2006

Expiration Date

03/31/2007

City

SPRINGFIELD

State

Zip

62712

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/14/2007