DESARAE SHAUNTEL GREEN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049210371

License Status

NOT RENEWED

Business

First Name

DESARAE

Middle

SHAUNTEL

Last Name

GREEN

Business Name

DESARAE SHAUNTEL GREEN

Original Issue Date

04/16/2012

Effective Date

04/16/2012

Expiration Date

03/31/2013

City

PEORIA

State

Zip

61604

County

PEORIA

Ever Disciplined

LastModifiedDate

05/06/2013