BRANDIE NICOLE DECLERCK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049188139

License Status

NOT RENEWED

Business

First Name

BRANDIE

Middle

NICOLE

Last Name

DECLERCK

Business Name

BRANDIE NICOLE DECLERCK

Original Issue Date

11/05/2008

Effective Date

04/02/2009

Expiration Date

03/31/2010

City

ROCK ISLAND

State

Zip

61201

County

ROCK ISLAND

Ever Disciplined

LastModifiedDate

05/04/2010