GRANT A TOLLY Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049165096

License Status

NOT RENEWED

Business

First Name

GRANT

Middle

Last Name

TOLLY

Business Name

GRANT A TOLLY

Original Issue Date

11/18/2005

Effective Date

11/18/2005

Expiration Date

03/31/2006

City

MOWEAQUA

State

Zip

62550

County

SHELBY

Ever Disciplined

LastModifiedDate

05/11/2006