JUSTIN A STORTZUM Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049159646

License Status

NOT RENEWED

Business

First Name

JUSTIN

Middle

Last Name

STORTZUM

Business Name

JUSTIN A STORTZUM

Original Issue Date

03/22/2005

Effective Date

03/22/2005

Expiration Date

03/31/2006

City

EFFINGHAM

State

Zip

62401

County

EFFINGHAM

Ever Disciplined

LastModifiedDate

05/11/2006