RAFAEL M L MOORE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049172879

License Status

NOT RENEWED

Business

First Name

RAFAEL

Middle

M L

Last Name

MOORE

Business Name

RAFAEL M L MOORE

Original Issue Date

11/30/2006

Effective Date

04/04/2011

Expiration Date

03/31/2012

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/07/2012