ELISE M BOUVILLAIN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049166408

License Status

NOT RENEWED

Business

First Name

ELISE

Middle

Last Name

BOUVILLAIN

Business Name

ELISE M BOUVILLAIN

Original Issue Date

01/31/2006

Effective Date

01/09/2007

Expiration Date

03/31/2008

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

05/02/2008