SHANE D RUGGLESS DMD Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049161095

License Status

NOT RENEWED

Business

Title

DMD

First Name

SHANE

Middle

Last Name

RUGGLESS

Business Name

SHANE D RUGGLESS DMD

Original Issue Date

05/17/2005

Effective Date

05/17/2005

Expiration Date

03/31/2006

City

ROCHESTER

State

Zip

62563

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/11/2006