CRYSTAL A MAYORGA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049156399

License Status

NOT RENEWED

Business

First Name

CRYSTAL

Middle

Last Name

MAYORGA

Business Name

CRYSTAL A MAYORGA

Original Issue Date

08/04/2004

Effective Date

08/04/2004

Expiration Date

03/31/2005

City

KEWANEE

State

Zip

61443

County

HENRY

Ever Disciplined

LastModifiedDate

10/20/2005