NICOLE R CRAWFORD Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049189438

License Status

NOT RENEWED

Business

First Name

NICOLE

Middle

Last Name

CRAWFORD

Prefix

Business Name

NICOLE R CRAWFORD

Original Issue Date

02/02/2009

Effective Date

02/02/2009

Expiration Date

03/31/2010

City

WOOD RIVER

State

Zip

62095

County

MADISON

Ever Disciplined

LastModifiedDate

06/11/2010

Case Number

2009006403

Action

Revocation

Discipline Start Date

06/11/2010

Discipline Reason

after knowingly diverted and possessed a controlled substance without authorization.