LATISHA L SIMON Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049196840

License Status

NOT RENEWED

Business

First Name

LATISHA

Middle

Last Name

SIMON

Business Name

LATISHA L SIMON

Original Issue Date

02/17/2010

Effective Date

02/17/2010

Expiration Date

03/31/2011

City

ROCKFORD

State

Zip

61101

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/12/2011