TRAVIS N WILLEFORD Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049162305

License Status

NOT RENEWED

Business

First Name

TRAVIS

Middle

Last Name

WILLEFORD

Business Name

TRAVIS N WILLEFORD

Original Issue Date

07/15/2005

Effective Date

02/11/2009

Expiration Date

03/31/2010

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/04/2010