MADELINE RAE COTHAM Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049177472

License Status

NOT RENEWED

Business

First Name

MADELINE

Middle

RAE

Last Name

COTHAM

Business Name

MADELINE RAE COTHAM

Original Issue Date

07/02/2007

Effective Date

01/10/2008

Expiration Date

03/31/2009

City

WASHINGTON

State

Zip

61571

County

TAZEWELL

Ever Disciplined

LastModifiedDate

05/06/2009