SHANE C SCHOMBURG Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049178995

License Status

NOT RENEWED

Business

First Name

SHANE

Middle

Last Name

SCHOMBURG

Business Name

SHANE C SCHOMBURG

Original Issue Date

09/05/2007

Effective Date

03/21/2011

Expiration Date

03/31/2012

City

SPRINGFIELD

State

Zip

62712

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/07/2012