NICHOLE A BROADHACKER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049173472

License Status

NOT RENEWED

Business

First Name

NICHOLE

Middle

Last Name

BROADHACKER

Business Name

NICHOLE A BROADHACKER

Original Issue Date

01/05/2007

Effective Date

04/17/2009

Expiration Date

03/31/2010

City

MACON

State

Zip

62544

County

MACON

Ever Disciplined

LastModifiedDate

05/04/2010