CAITLIN K FANTA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049196486

License Status

NOT RENEWED

Business

First Name

CAITLIN

Middle

Last Name

FANTA

Business Name

CAITLIN K FANTA

Original Issue Date

01/27/2010

Effective Date

01/27/2010

Expiration Date

03/31/2011

City

PEKIN

State

Zip

61554

County

TAZEWELL

Ever Disciplined

LastModifiedDate

05/12/2011