CORLISS SHONTA STATEN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049182559

License Status

NOT RENEWED

Business

First Name

CORLISS

Middle

SHONTA

Last Name

STATEN

Business Name

CORLISS SHONTA STATEN

Original Issue Date

03/04/2008

Effective Date

03/02/2009

Expiration Date

03/31/2010

City

ROCKFORD

State

Zip

61101

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/04/2010