SHANE L ORT Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049166599

License Status

NOT RENEWED

Business

First Name

SHANE

Middle

Last Name

ORT

Business Name

SHANE L ORT

Original Issue Date

03/03/2006

Effective Date

03/03/2006

Expiration Date

03/31/2007

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Ever Disciplined

LastModifiedDate

05/14/2007