AMANDA J ROSS MD Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049158463

License Status

NOT RENEWED

Business

First Name

AMANDA

Middle

Last Name

ROSS

Suffix

Business Name

AMANDA J ROSS MD

Original Issue Date

12/21/2004

Effective Date

01/09/2007

Expiration Date

03/31/2008

City

SPRINGFIELD

State

Zip

62712

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/02/2008