TELISHA M IVY Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049173081

License Status

NOT RENEWED

Business

First Name

TELISHA

Middle

Last Name

IVY

Business Name

TELISHA M IVY

Original Issue Date

12/11/2006

Effective Date

12/11/2006

Expiration Date

03/31/2007

City

ROCKFORD

State

Zip

61109

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/14/2007