ANGELINA MARIE BAUTISTA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049160374

License Status

NOT RENEWED

Business

First Name

ANGELINA

Middle

MARIE

Last Name

BAUTISTA

Business Name

ANGELINA MARIE BAUTISTA

Original Issue Date

04/20/2005

Effective Date

04/20/2005

Expiration Date

03/31/2006

City

MACHESNEY PARK

State

Zip

61115

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/11/2006