BEN DAVID VANDEURSEN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049172939

License Status

NOT RENEWED

Business

First Name

BEN

Middle

DAVID

Last Name

VANDEURSEN

Business Name

BEN DAVID VANDEURSEN

Original Issue Date

12/04/2006

Effective Date

03/12/2010

Expiration Date

03/31/2011

City

SULLIVAN

State

Zip

61951

County

MOULTRIE

Ever Disciplined

LastModifiedDate

05/12/2011