SAMANTHA M CICOGNA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049207660

License Status

NOT RENEWED

Business

First Name

SAMANTHA

Middle

Last Name

CICOGNA

Prefix

Business Name

SAMANTHA M CICOGNA

Original Issue Date

11/07/2011

Effective Date

11/07/2011

Expiration Date

03/31/2012

City

STILLMAN VALLEY

State

Zip

61084

County

OGLE

Ever Disciplined

LastModifiedDate

05/07/2012