BRIAN A BETHEA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049162503

License Status

NOT RENEWED

Business

First Name

BRIAN

Middle

Last Name

BETHEA

Business Name

BRIAN A BETHEA

Original Issue Date

07/26/2005

Effective Date

07/26/2005

Expiration Date

03/31/2006

City

ROCKFORD

State

Zip

61101

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/11/2006