CASEY A.T DIVELY Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049157277

License Status

NOT RENEWED

Business

First Name

CASEY

Middle

A.T

Last Name

DIVELY

Business Name

CASEY A.T DIVELY

Original Issue Date

10/04/2004

Effective Date

01/09/2007

Expiration Date

03/31/2008

City

TAYLORVILLE

State

Zip

62568

Ever Disciplined

LastModifiedDate

05/02/2008