SHANE O JOHNSON Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049160057

License Status

NOT RENEWED

Business

First Name

SHANE

Middle

Last Name

JOHNSON

Business Name

SHANE O JOHNSON

Original Issue Date

04/11/2005

Effective Date

03/30/2009

Expiration Date

03/31/2010

City

ROSCOE

State

Zip

61073

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/04/2010