BRENTON M WAYSTOUT Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049182630

License Status

NOT RENEWED

Business

First Name

BRENTON

Middle

Last Name

WAYSTOUT

Business Name

BRENTON M WAYSTOUT

Original Issue Date

03/07/2008

Effective Date

02/02/2009

Expiration Date

03/31/2010

City

NORMAL

State

Zip

61761

County

MCLEAN

Ever Disciplined

LastModifiedDate

05/04/2010