NICOLE L BLACK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049183860

License Status

NOT RENEWED

Business

First Name

NICOLE

Middle

Last Name

BLACK

Business Name

NICOLE L BLACK

Original Issue Date

04/24/2008

Effective Date

03/19/2009

Expiration Date

03/31/2010

City

ROCHESTER

State

Zip

62563

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/04/2010