BRENDA R SULLIVAN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049204138

License Status

NOT RENEWED

Business

First Name

BRENDA

Middle

Last Name

SULLIVAN

Business Name

BRENDA R SULLIVAN

Original Issue Date

05/16/2011

Effective Date

05/02/2012

Expiration Date

03/31/2013

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/06/2013