TIMOTHY J SHRAKE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049156536

License Status

NOT RENEWED

Business

First Name

TIMOTHY

Middle

Last Name

SHRAKE

Business Name

TIMOTHY J SHRAKE

Original Issue Date

08/11/2004

Effective Date

03/09/2010

Expiration Date

03/31/2011

City

SPRINGFIELD

State

Zip

62711

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/12/2011