DAVID MICHAEL FULLER Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049211154

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

MICHAEL

Last Name

FULLER

Business Name

DAVID MICHAEL FULLER

Original Issue Date

05/18/2012

Effective Date

01/08/2013

Expiration Date

03/31/2014

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Ever Disciplined

LastModifiedDate

05/06/2014