TIERRA R RUSSELL Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049209835

License Status

NOT RENEWED

Business

First Name

TIERRA

Middle

Last Name

RUSSELL

Business Name

TIERRA R RUSSELL

Original Issue Date

03/21/2012

Effective Date

03/21/2012

Expiration Date

03/31/2013

City

MARYVILLE

State

Zip

62062

County

MADISON

Ever Disciplined

LastModifiedDate

05/06/2013