CHRISTOPHER JORDAN MIEDEMA MD Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049176980

License Status

NOT RENEWED

Business

Title

First Name

CHRISTOPHER

Middle

JORDAN

Last Name

MIEDEMA

Business Name

CHRISTOPHER JORDAN MIEDEMA MD

Original Issue Date

06/13/2007

Effective Date

03/16/2010

Expiration Date

03/31/2011

City

SPRINGFIELD

State

Zip

62711

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/12/2011