SAMANTHA ANNE BERTHOUD Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049213274

License Status

NOT RENEWED

Business

First Name

SAMANTHA

Middle

ANNE

Last Name

BERTHOUD

Business Name

SAMANTHA ANNE BERTHOUD

Original Issue Date

09/04/2012

Effective Date

02/26/2014

Expiration Date

03/31/2015

City

CARBON CLIFF

State

Zip

61239

County

ROCK ISLAND

Ever Disciplined

LastModifiedDate

05/11/2015