STACIA SUE MARTIN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049156821

License Status

NOT RENEWED

Business

First Name

STACIA

Middle

SUE

Last Name

MARTIN

Business Name

STACIA SUE MARTIN

Original Issue Date

08/23/2004

Effective Date

01/09/2007

Expiration Date

03/31/2008

City

DECATUR

State

Zip

62521

County

MACON

Ever Disciplined

LastModifiedDate

01/14/2009

Case Number

2007003568

Action

Revocation

Discipline Start Date

01/14/2009

Discipline Reason

pharmacy technician license revoked for knowingly diverted and possessed controlled substances without authorization.