LACIE C MARTIN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049173163

License Status

NOT RENEWED

Business

First Name

LACIE

Middle

Last Name

MARTIN

Business Name

LACIE C MARTIN

Original Issue Date

12/14/2006

Effective Date

02/23/2011

Expiration Date

03/31/2012

City

GEORGETOWN

State

Zip

61846

County

VERMILION

Ever Disciplined

LastModifiedDate

05/07/2012