ALYSSA VANDERWULP Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049214112

License Status

NOT RENEWED

Business

First Name

ALYSSA

Last Name

VANDERWULP

Prefix

Business Name

ALYSSA VANDERWULP

Original Issue Date

10/18/2012

Effective Date

03/21/2013

Expiration Date

03/31/2014

City

PEORIA HEIGHTS

State

Zip

61616

County

PEORIA

Ever Disciplined

LastModifiedDate

05/06/2014