MATTIE A STOCKARD Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049172185

License Status

NOT RENEWED

Business

First Name

MATTIE

Middle

Last Name

STOCKARD

Business Name

MATTIE A STOCKARD

Original Issue Date

10/30/2006

Effective Date

01/09/2007

Expiration Date

03/31/2008

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/02/2008