NICOLE E PRUSATOR Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049207260

License Status

NOT RENEWED

Business

First Name

NICOLE

Middle

Last Name

PRUSATOR

Business Name

NICOLE E PRUSATOR

Original Issue Date

10/12/2011

Effective Date

01/24/2013

Expiration Date

03/31/2014

City

MENDOTA

State

Zip

61342

County

LA SALLE

Ever Disciplined

LastModifiedDate

05/06/2014