DEWAYNE K FENDERSON Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049158946

License Status

NOT RENEWED

Business

First Name

DEWAYNE

Middle

Last Name

FENDERSON

Business Name

DEWAYNE K FENDERSON

Original Issue Date

01/26/2005

Effective Date

03/11/2010

Expiration Date

03/31/2011

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/12/2011