AUTUMN MARIE SMITH Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049199787

License Status

NOT RENEWED

Business

First Name

AUTUMN

Middle

MARIE

Last Name

SMITH

Business Name

AUTUMN MARIE SMITH

Original Issue Date

08/05/2010

Effective Date

03/23/2011

Expiration Date

03/31/2012

City

LOVES PARK

State

Zip

61111

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/07/2012