AUTUMN IVY STEVENS Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049181540

License Status

NOT RENEWED

Business

First Name

AUTUMN

Middle

IVY

Last Name

STEVENS

Business Name

AUTUMN IVY STEVENS

Original Issue Date

01/14/2008

Effective Date

01/14/2008

Expiration Date

03/31/2009

City

GRANITE CITY

State

Zip

62040

County

MADISON

Ever Disciplined

LastModifiedDate

05/06/2009