TIFFANY M IRVIN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049204743

License Status

NOT RENEWED

Business

First Name

TIFFANY

Middle

Last Name

IRVIN

Business Name

TIFFANY M IRVIN

Original Issue Date

06/10/2011

Effective Date

03/15/2012

Expiration Date

03/31/2013

City

HARTFORD

State

Zip

62048

County

MADISON

Ever Disciplined

LastModifiedDate

05/06/2013