KATHERINE ANN FANTA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049179998

License Status

NOT RENEWED

Business

First Name

KATHERINE

Middle

ANN

Last Name

FANTA

Business Name

KATHERINE ANN FANTA

Original Issue Date

10/17/2007

Effective Date

10/17/2007

Expiration Date

03/31/2008

City

MORTON

State

Zip

61550

County

TAZEWELL

Ever Disciplined

LastModifiedDate

05/02/2008