SANDRA H BLACK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049163795

License Status

NOT RENEWED

Business

First Name

SANDRA

Middle

Last Name

BLACK

Business Name

SANDRA H BLACK

Original Issue Date

09/13/2005

Effective Date

09/13/2005

Expiration Date

03/31/2006

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/11/2006