TARA L WYZARD Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049172621

License Status

NOT RENEWED

Business

First Name

TARA

Middle

Last Name

WYZARD

Business Name

TARA L WYZARD

Original Issue Date

11/16/2006

Effective Date

02/14/2012

Expiration Date

03/31/2013

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/06/2013