DIANE M BERGMAN GOVIG Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049200807

License Status

NOT RENEWED

Business

First Name

DIANE

Middle

Last Name

BERGMAN GOVIG

Business Name

DIANE M BERGMAN GOVIG

Original Issue Date

09/30/2010

Effective Date

09/30/2010

Expiration Date

03/31/2011

City

OREGON

State

Zip

61061

County

OGLE

Ever Disciplined

LastModifiedDate

05/12/2011