TATIANA MADEP GONEZOCK NNOUNG Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049206221

License Status

NOT RENEWED

Business

First Name

TATIANA

Middle

MADEP

Last Name

GONEZOCK NNOUNG

Business Name

TATIANA MADEP GONEZOCK NNOUNG

Original Issue Date

08/25/2011

Effective Date

08/25/2011

Expiration Date

03/31/2012

City

CHAMPAIGN

State

Zip

61800

Ever Disciplined

LastModifiedDate

05/07/2012