ANDREW C GUSTAFSON Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049161842

License Status

NOT RENEWED

Business

First Name

ANDREW

Middle

Last Name

GUSTAFSON

Business Name

ANDREW C GUSTAFSON

Original Issue Date

06/23/2005

Effective Date

04/01/2010

Expiration Date

03/31/2011

City

SILVIS

State

Zip

61282

County

ROCK ISLAND

Ever Disciplined

LastModifiedDate

05/12/2011