MICHAEL J DERGANCE Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049191289

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

Last Name

DERGANCE

Business Name

MICHAEL J DERGANCE

Original Issue Date

04/24/2009

Effective Date

01/31/2011

Expiration Date

03/31/2012

City

OSWEGO

State

Zip

60543

County

KENDALL

Ever Disciplined

LastModifiedDate

05/07/2012