STEPHANIE L SULLIVAN MD Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049182243

License Status

NOT RENEWED

Business

Title

First Name

STEPHANIE

Middle

Last Name

SULLIVAN

Prefix

Business Name

STEPHANIE L SULLIVAN MD

Original Issue Date

02/19/2008

Effective Date

02/19/2008

Expiration Date

03/31/2009

City

EDWARDS

State

Zip

61528

County

PEORIA

Ever Disciplined

LastModifiedDate

05/06/2009