TARA JO BURGESS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049169598

License Status

NOT RENEWED

Business

First Name

TARA

Middle

Last Name

BURGESS

Business Name

TARA JO BURGESS

Original Issue Date

06/26/2006

Effective Date

03/09/2009

Expiration Date

03/31/2010

City

PALMYRA

State

Zip

62674

County

MACOUPIN

Ever Disciplined

LastModifiedDate

05/04/2010