FAWN M RUSSELL Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049187102

License Status

NOT RENEWED

Business

First Name

FAWN

Middle

Last Name

RUSSELL

Business Name

FAWN M RUSSELL

Original Issue Date

09/18/2008

Effective Date

02/08/2010

Expiration Date

03/31/2011

City

ROCK ISLAND

State

Zip

61204

Ever Disciplined

LastModifiedDate

05/12/2011