JUSTIN CHARLES BOUDEMAN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049176715

License Status

NOT RENEWED

Business

First Name

JUSTIN

Middle

CHARLES

Last Name

BOUDEMAN

Business Name

JUSTIN CHARLES BOUDEMAN

Original Issue Date

05/31/2007

Effective Date

03/18/2011

Expiration Date

03/31/2012

City

MCLEAN

State

Zip

61754

County

MCLEAN

Ever Disciplined

LastModifiedDate

05/07/2012