AMANDA VASTAG MD Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049178490

License Status

NOT RENEWED

Business

Title

First Name

AMANDA

Last Name

VASTAG

Business Name

AMANDA VASTAG MD

Original Issue Date

08/16/2007

Effective Date

08/16/2007

Expiration Date

03/31/2008

City

PEORIA

State

Zip

61615

County

PEORIA

Ever Disciplined

LastModifiedDate

05/02/2008