TRAVIS DONTE CROCKETT Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049188851

License Status

NOT RENEWED

Business

First Name

TRAVIS

Middle

DONTE

Last Name

CROCKETT

Business Name

TRAVIS DONTE CROCKETT

Original Issue Date

12/23/2008

Effective Date

03/30/2011

Expiration Date

03/31/2012

City

LANSING

State

Zip

60438

County

COOK

Ever Disciplined

LastModifiedDate

05/07/2012